Wilkinson County Senior Care - Centreville Nursing Home
General Information
UPDATEFederal Provider Number
255126
Provider Name
WILKINSON COUNTY SENIOR CARE
Provider Address
116 SOUTH LAFAYETTE STREET
CENTREVILLE, MS 39631
CENTREVILLE, MS 39631
Provider Phone Number
(601) 645-5253
Provider SSA County
780
Provider County Name
Wilkinson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
83
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILKINSON COUNTY SENIOR CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1989-06-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.13434
Reported LPN Staffing Hours per Resident per Day
0.68855
Reported RN Staffing Hours per Resident per Day
0.37229
Reported Licensed Staffing Hours per Resident per Day
1.06084
Reported Total Nurse Staffing Hours per Resident per Day
3.19518
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01386
Expected CNA Staffing Hours per Resident per Day
2.21788
Expected LPN Staffing Hours per Resident per Day
0.60601
Expected RN Staffing Hours per Resident per Day
0.98289
Expected Total Nurse Staffing Hours per Resident per Day
3.80678
Adjusted CNA Staffing Hours per Resident per Day
2.36128
Adjusted LPN Staffing Hours per Resident per Day
0.94304
Adjusted RN Staffing Hours per Resident per Day
0.28302
Adjusted Total Nurse Staffing Hours per Resident per Day
3.38329
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
16
Cycle 1 Standard Survey Health Date
2014-07-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-09-05
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
26.00000
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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