Willow Creek Retirement Center - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
255300
Provider Name
WILLOW CREEK RETIREMENT CENTER
Provider Address
49 WILLOW CREEK LANE
JACKSON, MS 39272
JACKSON, MS 39272
Provider Phone Number
(601) 863-4201
Provider SSA County
240
Provider County Name
Hinds
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
88
Number of Residents in Certified Beds
82
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WCRL, LLC
Date First Approved to Provide Medicare and Medicaid services
2003-08-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.35061
Reported LPN Staffing Hours per Resident per Day
1.29085
Reported RN Staffing Hours per Resident per Day
0.61037
Reported Licensed Staffing Hours per Resident per Day
1.90122
Reported Total Nurse Staffing Hours per Resident per Day
4.25183
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09512
Expected CNA Staffing Hours per Resident per Day
2.48966
Expected LPN Staffing Hours per Resident per Day
0.58254
Expected RN Staffing Hours per Resident per Day
0.90492
Expected Total Nurse Staffing Hours per Resident per Day
3.97712
Adjusted CNA Staffing Hours per Resident per Day
2.31666
Adjusted LPN Staffing Hours per Resident per Day
1.83919
Adjusted RN Staffing Hours per Resident per Day
0.50399
Adjusted Total Nurse Staffing Hours per Resident per Day
4.30932
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
14
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2013-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
50.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
3
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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