River Chase Village - Gautier Nursing Home
General Information
UPDATEFederal Provider Number
255289
Provider Name
RIVER CHASE VILLAGE
Provider Address
5090 GAUTIER VANCLEAVE ROAD
GAUTIER, MS 39553
GAUTIER, MS 39553
Provider Phone Number
(228) 522-6700
Provider SSA County
290
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SENTRY-GAUTIER, INC.
Date First Approved to Provide Medicare and Medicaid services
2002-08-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.56863
Reported LPN Staffing Hours per Resident per Day
0.78725
Reported RN Staffing Hours per Resident per Day
0.50686
Reported Licensed Staffing Hours per Resident per Day
1.29412
Reported Total Nurse Staffing Hours per Resident per Day
3.86274
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02255
Expected CNA Staffing Hours per Resident per Day
2.53112
Expected LPN Staffing Hours per Resident per Day
0.60840
Expected RN Staffing Hours per Resident per Day
0.87791
Expected Total Nurse Staffing Hours per Resident per Day
4.01743
Adjusted CNA Staffing Hours per Resident per Day
2.49006
Adjusted LPN Staffing Hours per Resident per Day
1.07399
Adjusted RN Staffing Hours per Resident per Day
0.43140
Adjusted Total Nurse Staffing Hours per Resident per Day
3.87569
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-11-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
0
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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