Cycle 1
Health 2024-10-03 · Fire 2024-10-03
9 health deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
1 fire-safety deficiencies
Top issue: Smoke (1 deficiency)
Columbia, MS
Myrtles Nursing Center, LLC
2-star overall rating with 3-star inspections with 9 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
1018 Alberta Avenue, Columbia, MS
(601) 731-1745
Overall
2 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
1 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
98
Certified beds
Average residents
81
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
The Beebe Family
Operator or chain grouping
Approved since
2001-05-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
48 facilities
Chain averages 3 overall / 3 health / 3 staffing / 2 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.44
Registered nurse staffing · state 0.63 · national 0.68
LPN hours / resident day
0.97
Licensed practical nurse staffing · state 1.10 · national 0.87
Aide hours / resident day
2.25
Nurse aide staffing · state 2.48 · national 2.35
Total nurse hours
3.66
All reported nurse hours · state 4.21 · national 3.89
Licensed hours
1.42
RN + LPN hours · state 1.73 · national 1.54
Weekend hours
3.09
Weekend nurse staffing · state 3.51 · national 3.43
Weekend RN hours
0.28
Weekend registered nurse coverage · state 0.37 · national 0.47
Physical therapist
0.01
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.52
CMS adjusted RN staffing hours
Adjusted total hours
4.32
CMS adjusted total nurse staffing hours
Case-mix index
1.16
Higher values indicate more complex resident acuity
RN turnover
46%
Annual RN turnover · state 43% · national 45%
Total nurse turnover
72%
Annual nurse turnover · state 48% · national 46%
SNF VBP
Value-based purchasing
Program rank
10,909
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
18.67
Composite VBP score used to determine payment impact.
Payment multiplier
0.9820
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.87
Baseline 23.10% · Performance 20.45% · Measure score 3.87 · Achievement 2.12 · Improvement 3.87
Healthcare-associated infections
0
Baseline 7.95% · Performance 8.17% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
0
Baseline 58.97% · Performance 68.18% · Measure score 0 · Achievement 0 · Improvement 0
Adjusted total nurse staffing
3.60
Baseline 3.74 hours · Performance 4.10 hours · Measure score 3.60 · Achievement 3.60 · Improvement 1.27
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 12.49% |
10.72%
1.8 pts worse
|
No Different than the National Rate · Eligible stays 107 · Observed rate 15.89% · Lower 95% interval 8.64% |
| Discharge to community | 45.87% |
50.57%
4.7 pts worse
|
No Different than the National Rate · Eligible stays 54 · Observed rate 31.48% · Lower 95% interval 32.55% |
| Medicare spending per beneficiary | 1.13 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 64.86% |
95.27%
30.4 pts worse
|
Numerator 48 · Denominator 74 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 74 |
| Discharge self-care score | 58.14% |
53.69%
4.5 pts better
|
Numerator 25 · Denominator 43 |
| Discharge mobility score | 53.49% |
50.94%
2.6 pts better
|
Numerator 23 · Denominator 43 |
| Pressure ulcers or injuries, new or worsened | 4.05% |
2.29%
1.8 pts worse
|
Numerator 3 · Denominator 74 · Adjusted rate 3.05% |
| Healthcare-associated infections requiring hospitalization | 8.17% |
7.12%
1 pts worse
|
No Different than the National Rate · Eligible stays 69 · Observed rate 11.59% · Lower 95% interval 4.64% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 102 |
| Staff flu vaccination coverage | 26.92% |
42%
15.1 pts worse
|
Numerator 28 · Denominator 104 |
| Discharge function score | 53.49% |
56.45%
3 pts worse
|
Numerator 23 · Denominator 43 |
| Transfer of health information to provider | 81.48% |
95.95%
14.5 pts worse
|
Numerator 22 · Denominator 27 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 9 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 21.05% |
25.2%
4.1 pts worse
|
Numerator 8 · Denominator 38 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.3 |
2.4
0.1 pts better
|
1.9
0.4 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.3 · Observed 2.4 · Expected 1.9 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 6.0 |
2.9
3.1 pts worse
|
1.8
4.2 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 6.0 · Observed 5.9 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.8% |
95.7%
3.1 pts better
|
93.4%
5.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 96.5% · Q2 98.8% · Q3 100.0% · Q4 100.0% · 4Q avg 98.8% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 96.7% |
97.0%
0.3 pts worse
|
95.5%
1.2 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 96.7% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.1% |
3.2%
1.1 pts better
|
3.3%
1.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.7% · Q2 2.4% · Q3 1.2% · Q4 0.0% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.7% |
1.6%
0.9 pts better
|
11.4%
10.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 1.3% · Q3 0.0% · Q4 0.0% · 4Q avg 0.7% |
| Percentage of long-stay residents who lose too much weight | 8.8% |
6.1%
2.7 pts worse
|
5.4%
3.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.8% · Q2 12.5% · Q3 16.7% · Q4 0.0% · 4Q avg 8.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 32.6% |
24.4%
8.2 pts worse
|
19.6%
13 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 32.9% · Q2 31.1% · Q3 32.9% · Q4 33.8% · 4Q avg 32.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 22.2% |
23.4%
1.2 pts better
|
16.7%
5.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 17.9% · Q2 23.3% · Q3 23.2% · Q4 24.1% · 4Q avg 22.2% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 29.3% |
22.8%
6.5 pts worse
|
16.3%
13 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 39.7% · Q2 16.6% · Q3 25.2% · Q4 33.4% · 4Q avg 29.3% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 29.6% |
20.6%
9 pts worse
|
14.9%
14.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 41.8% · Q2 21.5% · Q3 24.2% · Q4 30.3% · 4Q avg 29.6% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 3.8% |
1.5%
2.3 pts worse
|
1.0%
2.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.5% · Q2 4.4% · Q3 3.2% · Q4 2.0% · 4Q avg 3.8% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 3.2% |
2.5%
0.7 pts worse
|
1.7%
1.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.0% · Q2 2.7% · Q3 3.9% · Q4 0.0% · 4Q avg 3.2% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 31.7% |
21.4%
10.3 pts worse
|
19.8%
11.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 33.9% · Q2 34.1% · Q3 32.1% · Q4 26.6% · 4Q avg 31.7% |
| Percentage of long-stay residents with pressure ulcers | 4.6% |
6.9%
2.3 pts better
|
5.1%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.7% · Q2 6.8% · Q3 6.5% · Q4 1.8% · 4Q avg 4.6% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 94.2% |
87.9%
6.3 pts better
|
81.7%
12.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 86.1% · Q4 93.0% · 4Q avg 94.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 22.7% |
15.3%
7.4 pts worse
|
12.0%
10.7 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 22.7% · Observed 25.6% · Expected 12.6% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.5% |
2.6%
1.1 pts better
|
1.6%
0.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q4 4.5% · 4Q avg 1.5% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 83.9% |
84.6%
0.7 pts worse
|
79.7%
4.2 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 83.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 38.3% |
27.9%
10.4 pts worse
|
23.9%
14.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 38.3% · Observed 42.7% · Expected 26.6% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-02-09 · Fire 2023-02-09
2 health deficiencies
Top issue: Infection Control (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2019-07-19 · Fire 2019-07-19
7 health deficiencies
Top issue: Resident Assessment and Care Planning (4 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2024-10-03
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2024-10-22
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-12-18
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2026-01-29
E · Potential for more than minimal harm
2024-10-03
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F625 · Resident Rights Deficiencies
Health
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F636 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F640 · Resident Assessment and Care Planning Deficiencies
Health
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F803 · Nutrition and Dietary Deficiencies
Health
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-10-03
F865 · Administration Deficiencies
Health
Have a plan that describes the process for conducting QAPI and QAA activities.
Corrected 2024-10-24
D · Potential for more than minimal harm
2024-06-27
F583 · Resident Rights Deficiencies
Health
Keep residents' personal and medical records private and confidential.
Corrected 2024-07-26
D · Potential for more than minimal harm
2023-02-09
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-03-10
E · Potential for more than minimal harm
2019-07-19
F690 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2019-08-13
E · Potential for more than minimal harm
2019-07-19
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2019-08-13
D · Potential for more than minimal harm
2019-07-19
F583 · Resident Rights Deficiencies
Health
Keep residents' personal and medical records private and confidential.
Corrected 2019-08-13
D · Potential for more than minimal harm
2019-07-19
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2019-08-13
D · Potential for more than minimal harm
2019-07-19
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2019-08-13
D · Potential for more than minimal harm
2019-07-19
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2019-08-13
C · Minimal harm
2019-07-19
F645 · Resident Assessment and Care Planning Deficiencies
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2019-08-13
Penalties and ownership
What sits behind the stars
Ownership
Elton G Beebe Sr Limited Ptrshp Tr
5% Or Greater Direct Ownership Interest · Organization
Account Management Services Inc
Operational/Managerial Control · Organization
Administrative Systems Inc
Operational/Managerial Control · Organization
Beebe, Bobby
Operational/Managerial Control · Individual
Beebe, Tracy
Operational/Managerial Control · Individual
Beebe, Tracy
Corporate Director · Individual
Griffith, Charles
Operational/Managerial Control · Individual
Kelly, Brianna
Operational/Managerial Control · Individual
Martin, Kourtney
Operational/Managerial Control · Individual
Parkinson, Toni
Operational/Managerial Control · Individual
Parkinson, Toni
Corporate Officer · Individual
Provider Professional Services Inc
Operational/Managerial Control · Organization
Regional Care LLC
Operational/Managerial Control · Organization
Regional Services, Inc
Operational/Managerial Control · Organization
Tristar Rehab Inc
Operational/Managerial Control · Organization
Nearby options
Other facilities in reach
#1
The Grove
Columbia, MS
4-star overall rating with 5-star inspections with 2 recent health deficiencies
#2
Columbia Rehabilitation And Healthcare Center
Columbia, MS
4-star overall rating with 4-star inspections with 6 recent health deficiencies
#3
Billdora Senior Care
Tylertown, MS
2-star overall rating with 3-star inspections with $11,625 in total fines with 5 recent health deficiencies
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