Pine Crest Guest Home Inc - Hazlehurst Nursing Home
General Information
UPDATEFederal Provider Number
255210
Provider Name
PINE CREST GUEST HOME INC
Provider Address
133 PINE STREET
HAZLEHURST, MS 39083
HAZLEHURST, MS 39083
Provider Phone Number
(601) 894-1411
Provider SSA County
140
Provider County Name
Copiah
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINECREST LLC
Date First Approved to Provide Medicare and Medicaid services
1995-08-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.70464
Reported LPN Staffing Hours per Resident per Day
1.10412
Reported RN Staffing Hours per Resident per Day
0.46237
Reported Licensed Staffing Hours per Resident per Day
1.56649
Reported Total Nurse Staffing Hours per Resident per Day
4.27113
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.11068
Expected LPN Staffing Hours per Resident per Day
0.58278
Expected RN Staffing Hours per Resident per Day
0.82405
Expected Total Nurse Staffing Hours per Resident per Day
3.51751
Adjusted CNA Staffing Hours per Resident per Day
3.14418
Adjusted LPN Staffing Hours per Resident per Day
1.57249
Adjusted RN Staffing Hours per Resident per Day
0.41925
Adjusted Total Nurse Staffing Hours per Resident per Day
4.89451
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
116
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
40.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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Nursiong Homes Nearby
Copiah Living Center
806 West Georgetown Street |
CRYSTAL SPRINGS MS 39059 | 8.9 miles away