Vicksburg Convalescent Center - Vicksburg Nursing Home
General Information
UPDATEFederal Provider Number
255253
Provider Name
VICKSBURG CONVALESCENT CENTER
Provider Address
1708 CHERRY STREET
VICKSBURG, MS 39180
VICKSBURG, MS 39180
Provider Phone Number
(601) 638-3632
Provider SSA County
740
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VICKSBURG CONVALESCENT, LLC
Date First Approved to Provide Medicare and Medicaid services
1998-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
1.91782
Reported LPN Staffing Hours per Resident per Day
0.68793
Reported RN Staffing Hours per Resident per Day
0.96609
Reported Licensed Staffing Hours per Resident per Day
1.65402
Reported Total Nurse Staffing Hours per Resident per Day
3.57184
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02644
Expected CNA Staffing Hours per Resident per Day
2.36707
Expected LPN Staffing Hours per Resident per Day
0.55721
Expected RN Staffing Hours per Resident per Day
0.79884
Expected Total Nurse Staffing Hours per Resident per Day
3.72312
Adjusted CNA Staffing Hours per Resident per Day
1.98801
Adjusted LPN Staffing Hours per Resident per Day
1.02472
Adjusted RN Staffing Hours per Resident per Day
0.90363
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86711
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2014-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-04-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
14.66700
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
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