Pleasant Hills Com Liv Center - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
255112
Provider Name
PLEASANT HILLS COM LIV CENTER
Provider Address
1600 RAYMOND RD
JACKSON, MS 39204
JACKSON, MS 39204
Provider Phone Number
(601) 371-1700
Provider SSA County
240
Provider County Name
Hinds
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
120
Number of Residents in Certified Beds
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLC OF JACKSON, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-04-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.93496
Reported LPN Staffing Hours per Resident per Day
1.03717
Reported RN Staffing Hours per Resident per Day
0.29071
Reported Licensed Staffing Hours per Resident per Day
1.32788
Reported Total Nurse Staffing Hours per Resident per Day
3.26284
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05044
Expected CNA Staffing Hours per Resident per Day
2.41822
Expected LPN Staffing Hours per Resident per Day
0.67444
Expected RN Staffing Hours per Resident per Day
1.04653
Expected Total Nurse Staffing Hours per Resident per Day
4.13919
Adjusted CNA Staffing Hours per Resident per Day
1.96335
Adjusted LPN Staffing Hours per Resident per Day
1.27640
Adjusted RN Staffing Hours per Resident per Day
0.20756
Adjusted Total Nurse Staffing Hours per Resident per Day
3.17748
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-08-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-09-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
58.66700
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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