Tishomingo Manor - Iuka Nursing Home
General Information
UPDATEFederal Provider Number
255218
Provider Name
TISHOMINGO MANOR
Provider Address
230 KHAKI STREET
IUKA, MS 38852
IUKA, MS 38852
Provider Phone Number
6624239112
Provider SSA County
700
Provider County Name
Tishomingo
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TISHOMINGO COMMUNITY CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1996-01-01
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
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.46296
Reported LPN Staffing Hours per Resident per Day
0.69259
Reported RN Staffing Hours per Resident per Day
1.10617
Reported Licensed Staffing Hours per Resident per Day
1.79877
Reported Total Nurse Staffing Hours per Resident per Day
4.26172
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01420
Expected CNA Staffing Hours per Resident per Day
2.63119
Expected LPN Staffing Hours per Resident per Day
0.72864
Expected RN Staffing Hours per Resident per Day
1.09442
Expected Total Nurse Staffing Hours per Resident per Day
4.45425
Adjusted CNA Staffing Hours per Resident per Day
2.29681
Adjusted LPN Staffing Hours per Resident per Day
0.78894
Adjusted RN Staffing Hours per Resident per Day
0.75522
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85667
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-11-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
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
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-09-20
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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
Nursiong Homes Nearby
Tishomingo Comm Living Center
1410 West Quitman Street |
IUKA MS 38852 | 3.3 miles away
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