CCN 25A188
Bolivar Medical Center LTC
901 E SUNFLOWER RD, Cleveland, MS 38732 · Bolivar County
- Ownership
- For profit - Corporation
- Certified beds
- 35
- Residents per day
- 29.0
- Health citations
- 5
- Penalties
- 0
- Fines
- 0 · $0
Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Staffing hours
Reported hours per resident per day come from the Payroll-Based Journal figures in the Provider Information file. Case-mix and adjusted hours account for how much care CMS expects given the residents’ needs. State and U.S. figures are averages from the same release.
- Measure
- This home
- State
- U.S.
- Nurse aide
- 2.34
- 2.43
- 2.32
- LPN/LVN
- 1.33
- 1.11
- 0.86
- Registered nurse
- 0.77
- 0.64
- 0.69
- Total nurse staff
- 4.43
- 4.18
- 3.86
- Weekend total
- 3.86
- 3.50
- 3.42
- Weekend RN
- 0.55
- 0.38
- 0.48
Adjusted total nurse hours: 4.50. Adjusted RN hours: 0.78. Case-mix total: 3.77. Case-mix index: 1.380.
Total nursing staff turnover: 53.8%. RN turnover: 44.4%. Administrators who left: —.
How to read staffing hours
Payroll-Based Journal figures in Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Fines and penalties
CMS reports 0 fines totaling $0, and 0 payment denials.
The Penalties file has no individual penalty rows for this CCN.
Cycle 1 standard survey: July 31, 2025. Health deficiencies counted in cycle 1: 3. Cycle 1 total health score: 36.
Cycle 2 standard survey: December 14, 2023. Cycle 2/3 health deficiencies: 0. Total weighted health survey score: 27.
Penalties file and Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Health inspection citations
The Health Deficiencies file lists 5 citations for this home, including 0 at immediate jeopardy and 0 at actual harm. CMS may display some citations here that are not used in the health inspection rating, including citations under dispute.
July 31, 2025
3 citations
| Tag | What CMS cited | Scope and severity | Status |
|---|
| F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Standard survey · Cycle 1 | F: widespread, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · September 5, 2025 |
| F851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. Administration Deficiencies · Standard survey · Cycle 1 | F: widespread, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · September 5, 2025 |
| F641 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Standard survey · Cycle 1 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · September 5, 2025 |
October 12, 2022
2 citations
| Tag | What CMS cited | Scope and severity | Status |
|---|
| F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Standard survey · Cycle 3 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · November 10, 2022 |
| F677 | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Standard survey · Cycle 3 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · November 10, 2022 |
Health Deficiencies. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections