Provider Name: BOLIVAR MEDICAL CENTER LTC
Address: 901 E SUNFLOWER RD, CLEVELAND, MS 38732
Phone: (662) 846-2520
County: Bolivar (050)
Ownership Type: For profit - Corporation
Certified Beds: 35
Average Residents Per Day: 24.4 ()
Provider Type: Medicaid, Resides in Hospital: No
Legal Business Name: Legal Business Name Not Available
First Approved Date: April 29, 1976
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Both
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 2 ()
Long Stay QM Rating: 2 ()
Short Stay QM Rating: (2)
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.02314, LPN Staff Hours Per Day: 1.2646, RN Staff Hours Per Day: 1.1914, Licensed Staff Hours Per Day: 2.4561
Total Nurse Staff Hours Per Day, per resident: 4.47928
Weekend Nurse Staff Hours: 2.84184, Weekend RN Staff Hours: 0.5186
PT Staff Hours Per Day, per resident: 0.0000
Nurse Staff Turnover: 51.4, Nurse Turnover Note:
RN Turnover: 33.3, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0167, Case Mix LPN Hours Per Day: 0.6724, Case Mix RN Hours Per Day: 0.2350
Adjusted Nurse Aide Hours Per Day, per resident: 2.04374, Adjusted LPN Hours Per Day: 1.3878, Adjusted RN Hours Per Day: 1.9097
Total Adjusted Nurse Hours Per Day, per resident: 4.82815
Adjusted Weekend Nurse Hours Per Day, per resident: 3.06318
Health Survey Dates and Scores: Cycle 1: 2023-12-14 (Score: 0), Cycle 2: 2022-10-12 (Score: 8), Cycle 3: 2019-09-19 (Score: 20)
Total Weighted Health Score: 6.000
Reported Incidents: 3, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 650.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 901 E SUNFLOWER RD,CLEVELAND,MS,38732 (33.7475, -90.709)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-11-10
Type: Health, Deficiency: Provide care and assistance to perform activities of daily living for any resident who is unable.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-11-10
Type: Health, Deficiency: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-05
Type: Health, Deficiency: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-05
Type: Health, Deficiency: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-05
Type: Health, Deficiency: Ensure each resident receives an accurate assessment.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-10-18
Type: Health, Deficiency: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-10-18
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications: