Yalobusha County Nursing Home - Water Valley Nursing Home
General Information
UPDATEFederal Provider Number
25A174
Provider Name
YALOBUSHA COUNTY NURSING HOME
Provider Address
630 SOUTH MAIN STREET/P. O. BOX 728
WATER VALLEY, MS 38965
WATER VALLEY, MS 38965
Provider Phone Number
(662) 473-1411
Provider SSA County
800
Provider County Name
Yalobusha
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
122
Number of Residents in Certified Beds
114
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.48596
Reported LPN Staffing Hours per Resident per Day
1.00000
Reported RN Staffing Hours per Resident per Day
0.69693
Reported Licensed Staffing Hours per Resident per Day
1.69693
Reported Total Nurse Staffing Hours per Resident per Day
4.18289
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07500
Expected CNA Staffing Hours per Resident per Day
2.26857
Expected LPN Staffing Hours per Resident per Day
0.58927
Expected RN Staffing Hours per Resident per Day
0.89085
Expected Total Nurse Staffing Hours per Resident per Day
3.74869
Adjusted CNA Staffing Hours per Resident per Day
2.68883
Adjusted LPN Staffing Hours per Resident per Day
1.40851
Adjusted RN Staffing Hours per Resident per Day
0.58455
Adjusted Total Nurse Staffing Hours per Resident per Day
4.49778
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-08-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
18.66700
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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