1_AttachmentJ-17MSPrUlcerandPhysRestraint.pdf

Targeted for Improvement in High-risk

Pressure Ulcer Rates

Targeted for Improvement in Physical Restraint

Rates

Provider Number Name

Total # of Beds

(including Non-participating)

City County ZIP Code

X* 255173 GLENBURNEY NURSING HOME 96 NATCHEZ ADAMS 39120

X* 255232 CORNERSTONE HEALTH AND REHAB OF CORINTH, LLC 95 CORINTH ALCORN 38834

X 255110 MS CARE CENTER OF ALCORN COUNTY LLC-SNF 125 CORINTH ALCORN 38834

X X 255138 BRIARCREST EXTENDED CARE 60 ASHLAND BENTON 38603

X 255228 BOLIVAR HEALTH & REHAB CTR 75 CLEVELAND BOLIVAR 38732

X 25A188 BOLIVAR MEDICAL CENTER LTC 35 CLEVELAND BOLIVAR 38732

X 25E115 OAK GROVE RETIREMENT HOME 60 DUNCAN BOLIVAR 38740

X 25A382 BRUCE COMMUNTIY LIVING CENTER 35 BRUCE CALHOUN 38915

X 25A233 CALHOUN CO NH 120 CALHOUN CITY CALHOUN 38916

X 25A117 CHOCTAW COUNTY NURSING CENTER 73 ACKERMAN CHOCTAW 39735

X 255215 COVINGTON CO NURSING CENTER 60 COLLINS COVINGTON 39428

X 255281 LANDMARK OF DESOTO 60 HORN LAKE DESOTO 38637

X 255158 BEDFORD CARE CENTER OF HATTIES 162 HATTIESBURG FORREST 39401

X* X 255149 BEDFORD CARE CENTER OF PETAL 60 PETAL FORREST 39465

X* 255297 BEDFORD CARE CTR-MONROE HALL 60 HATTIESBURG FORREST 39401

X 255265 WINDHAM HOUSE OF HATTIESBURG 60 HATTIESBURG FORREST 39402

X 255181 GLENOAKS NURSING CENTER 60 LUCEDALE GEORGE 39452

X 255277 GREENE RURAL HEALTH CENTER 60 LEAKESVILLE GREENE 39451

X* X 255156 GRACE HEALTH AND REHAB OF GRENADA, LLC 137 GRENADA GRENADA 38901

X 255104 GRENADA LIVING CENTER 120 GRENADA GRENADA 38901

X* 255093 BILOXI COMMUNITY LIVING CENTER 240 BILOXI HARRISON 39531

X 255287 DIXIE WHITE HOUSE NURSING HOME 60 PASS CHRISTIAN HARRISON 39571

X 255182 LAKEVIEW NURSING CENTER 105 GULFPORT HARRISON 39503

X 255273 FOREST HILL NURSING CENTER INC 87 JACKSON HINDS 39212

X 255103 HINDS COUNTY NURSING & REHABILITATION CTR LLC 119 JACKSON HINDS 39213

X 255115 MANHATTAN NURSING AND REHABILITATION CENTER LLC 180 JACKSON HINDS 39206

X 255259 HUMPHREYS CO NURSING CENTER 60 BELZONI HUMPHREYS 39038

X 255212 COURTYARDS COMM LIVING CENTER 66 FULTON ITAWAMBA 38843

X 255142 OCEAN SPRINGS NURSING CENTER 115 OCEAN SPRINGS JACKSON 39564

X 255174 SINGING RIVER REHAB & NURS CTR 160 MOSS POINT JACKSON 39563

X* 255244 SUNPLEX SUB-ACUTE CENTER 73 OCEAN SPRINGS JACKSON 39564

X 25A178 JASPER CO NH 110 BAY SPRINGS JASPER 39422

X* 255164 JEFFERSON COUNTY NURSING HOME 60 FAYETTE JEFFERSON 39069

X* 25A415 JONES CO REST HOME 122 ELLISVILLE JONES 39437

X* 255295 GUARDIAN ANGEL HEALTH CARE INC 128 MARION LAUDERDALE 39342

X* 255166 QUEEN CITY NURSING CENTER 84 MERIDIAN LAUDERDALE 39301

X 255214 LAWRENCE CO NURSING CENTER 60 MONTICELLO LAWRENCE 39654

MS Nursing Homes Targeted for Improvement Based on Quality Measure Scores as Calculated by CMS

NOTE: For more information about CMS' quality measures for nursing homes, please visit the Nursing Home Compare tool at http://www.medicare.gov/NHCompare.

The QIO may recruit up to 15% of the total number of providers they will work with from among providers not included in the J-17. The QIO must submit the criteria used to select these providers in their proposal to CMS. In no case may the total number of providers exceed the maximum number of providers as specified in Table B nor may the number of providers not identified in the J-17 exceed 15% of the total number of the providers the QIO recruits to work with.

X 255309 CEDARS HEALTH CENTER 140 TUPELO LEE 38801

X 255216 RIVERVIEW NURSING & REHABILITATION CENTER 120 GREENWOOD LEFLORE 38930

X 255162 COUNTRYBROOK LIVING CENTER 121 BROOKHAVEN LINCOLN 39601

X 255257 THE WINDSOR PLACE 140 COLUMBUS LOWNDES 39702

X 255222 TRINITY HEALTHCARE CENTER 60 COLUMBUS LOWNDES 39702

X* X 255274 HIGHLAND HOME 120 RIDGELAND MADISON 39157

X* X 255311 TRINITY MISSION H & R GREAT OAKS, LLC 60 BYHALIA MARSHALL 38611

X* 255229 TRINITY MISSION HEALTH & REHAB OF H S 120 HOLLY SPRINGS MARSHALL 38635

X 255097 CARE CENTER OF ABERDEEN 120 ABERDEEN MONROE 39730

X 255305 RIVER PLACE NURSING CENTER 60 AMORY MONROE 38821

X* 25A374 NOXUBEE COUNTY NURSING HOME 60 MACON NOXUBEE 39341

X* 255301 CARRINGTON, LLC D/B/A THE CARRINGTON 60 STARKVILLE OKTIBBEHA 39759

X* 255141 COVENANT HEALTH & REHAB OF PICAYUNE, LP 120 PICAYUNE PEARL RIVER 39466

X 255159 PERRY COUNTY NURSING CENTER 60 RICHTON PERRY 39476

X 255280 CAMELLIA ESTATES 30 MCCOMB PIKE 39648

X* 255145 MCCOMB EXTENDED CARE FACILITY 145 MCCOMB PIKE 39648

X 255319 SUNSHINE HEALTH CARE, INC 60 PONTOTOC PONTOTOC 38863

X 25A378 QUITMAN COUNTY NURSING HOME 60 MARKS QUITMAN 38646

X 255266 BRANDON COURT 100 BRANDON RANKIN 39042

X* 25A403 JNH-ADAMS INN 59 WHITFIELD RANKIN 39193

X 25A401 JNH-MONROE INN 88 WHITFIELD RANKIN 39193

X* 25A414 METHODIST SPECIALTY CARE CENTER 60 FLOWOOD RANKIN 39232

X 255220 HERITAGE MANOR OF ROLLING FORK 54 ROLLING FORK SHARKEY 39159

X 255150 BEDFORD CARE CENTER OF MENDENH 60 MENDENHALL SIMPSON 39114

X 25A391 ROLLING ACRES RETIREMENT CENTE 121 RALEIGH SMITH 39153

X 255233 AZALEA GARDENS NURSING CENTER 149 WIGGINS STONE 39577

X 255185 INDIANOLA HEALTH & REHABILITATION CENTER 75 INDIANOLA SUNFLOWER 38751

X 255113 RULEVILLE NURSING AND REHABILITATION CENTER LLC 109 RULEVILLE SUNFLOWER 38771

X 255302 SENATOBIA CONVALESCENT CENTER 120 SENATOBIA TATE 38668

X 255218 TISHOMINGO MANOR 105 IUKA TISHOMINGO 38852

X* X 255234 SHADY LAWN NURSING HOME 100 VICKSBURG WARREN 39180

X* 255253 VICKSBURG CONVALESCENT HOME 100 VICKSBURG WARREN 39180

X* 255217 ARNOLD AVENUE NURSING HOME 60 GREENVILLE WASHINGTON 38701

X* X 255219 AUTUMN LEAVES NURSING HOME 60 GREENVILLE WASHINGTON 38703

X 255292 LEGACY MANOR NURSING AND REHABILITATION 60 GREENVILLE WASHINGTON 38701

X 255314 WASHINGTON CARE CENTER 60 GREENVILLE WASHINGTON 38703

* = indicates the presence of at least one hospital in the same county

Provider Number Name City County

ZIP

Code

250122 NATCHEZ COMMUNITY HOSPITAL NATCHEZ ADAMS 39120

250084 NATCHEZ REGIONAL MEDICAL CENTER NATCHEZ ADAMS 39121

250009 MAGNOLIA HOSPITAL CORINTH ALCORN 38834

250078 FORREST GENERAL HOSPITAL HATTIESBURG FORREST 39402

250157 REGENCY HOSPITAL OF HATTIESBURG HATTIESBURG FORREST 39404

250015 GRENADA LAKE MEDICAL CENTER GRENADA GRENADA 38901

250007 BILOXI REGIONAL MEDICAL CENTER BILOXI HARRISON 39533

250123 GARDEN PARK COMMUNITY HOSPITAL GULFPORT HARRISON 39503

250125 GULF COAST MEDICAL CENTER BILOXI HARRISON 39531

250019 MEMORIAL HOSPITAL AT GULFPORT GULFPORT HARRISON 39502

250040 SINGING RIVER HOSPITAL SYSTEM PASCAGOULA JACKSON 39581

250060 JEFFERSON COUNTY HOSPITAL FAYETTE JEFFERSON 39069

250058 SOUTH CENTRAL REGIONAL MEDICAL CENTR LAUREL JONES 39441

250159 ALLIANCE LAIRD HOSPITAL MERIDIAN LAUDERDALE 39303

250104 JEFF ANDERSON HOSPITAL MERIDIAN LAUDERDALE 39301

250155 REGENCY HOSPITAL OF MERIDIAN MERIDIAN LAUDERDALE 39301

250069 RUSH FOUNDATION HOSPITAL MERIDIAN LAUDERDALE 39301

250038 MADISON REGIONAL MEDICAL CENTER CANTON MADISON 39046

250012 ALLIANCE HEALTHCARE SYSTEM HOLLY SPRINGS MARSHALL 38634

251307 NOXUBEE COUNTY HOSPITAL MACON NOXUBEE 39341

250050 OKTIBBEHA COUNTY HOSPITAL STARKVILLE OKTIBBEHA 39759

250117 HIGHLAND COMMUNITY HOSPITAL PICAYUNE PEARL RIVER 39455

250023 PEARL RIVER COUNTY HOSPITAL POPLARVILLE PEARL RIVER 39470

250049 SOUTH PIKE HOSPITAL ASSOCIATION MAGNOLIA PIKE 39652

250097 SOUTHWEST MS REG MED CENTER MCCOMB PIKE 39648

MS Hospitals Located in Counties with Nursing Homes that Are Targeted for Improvement in High-Risk Pressure Ulcer Rates

Based on Quality Measure Scores as Calculated by CMS

The QIO may recruit up to 15% of the total number of providers they will work with from among providers not included in the J-17. The QIO must submit the criteria used to select these providers in their proposal to CMS. In no case may the total number of providers exceed the maximum number of providers as specified in Table B nor may the number of providers not identified in the J-17 exceed 15% of the total number of the providers the QIO recruits to work with.

250096 RANKIN MEDICAL CENTER BRANDON RANKIN 39042

250138 RIVER OAKS HOSPITAL JACKSON RANKIN 39296

250134 WHITFIELD MEDICAL SURGICAL CENTER WHITFIELD RANKIN 39193

250136 WOMAN S HOSPITAL AT RIVER OAKS JACKSON RANKIN 39208

250032 PARKVIEW REGIONAL MEDICAL CTR VICKSBURG WARREN 39180

250158 PROMISE SPECIALTY HOSPITAL OF VICKSB VICKSBURG WARREN 39180

250031 RIVER REGION MEDICAL CORP VICKSBURG WARREN 39183

250082 DELTA REGIONAL MEDICAL CENTER GREENVILLE WASHINGTON 38704

250120 KING S DAUGHTERS HOSPITAL GREENVILLE WASHINGTON 38702