Great Oaks Rehabilitation and Healthcare Center
Great Oaks Rehabilitation and Healthcare Center is a for profit - corporation facility in Byhalia, MS with 60 certified beds and a 1-star overall CMS rating. The inspection file holds 24 deficiency records. Total penalties: $14K.
111 Chase Street, Byhalia, MS 38611
Phone: 6628383670
Overall CMS Rating
vs 3.0 national avg
The verdict
Great Oaks Rehabilitation and Healthcare Center holds a 1-star CMS overall rating — below the 3.0-star national average, with nurse staffing above the national norm. 1 inspection finding reached the actual-harm or immediate-jeopardy level.
- 1 / 5
- CMS overall rating (nat'l avg 3.0)
- 4.20
- Nursing hrs/resident-day (nat'l 3.89)
- 24
- Inspection findings on file · 1 serious
- $14K
- Federal penalties (1)
CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating. Read the components below — they often tell a sharper story than the headline.
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 255311
- Ownership
- For profit - Corporation
- Provider Type
- Medicare and Medicaid
- Beds
- 60
- Residents
- 50
- In Hospital
- No
- County
- Marshall
- Last Inspection
- Jun 25, 2025
Staffing Data
- RN Hours
- 0.50 (nat'l avg: 0.68)
- LPN Hours
- 1.55
- CNA Hours
- 2.15
- Total Nursing Hours
- 4.20 (nat'l avg: 3.89)
- PT Hours
- 0.02
- Nursing Turnover
- 60.7%
- RN Turnover
- 25.0%
What the CMS Record Reveals About Great Oaks Rehabilitation and Healthcare Center
Great Oaks Rehabilitation and Healthcare Center operates 60 certified beds in Byhalia, MS with approximately 50 residents currently in care, and carries a CMS overall rating of 1 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (2★), staffing levels (4★), and quality measures (1★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone — a 3-star facility with weak inspection history reads differently from one held back by thin staffing.
The inspection file contains 24 deficiency records from recent surveys, of which 1 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 1 penalty totaling $14K against this provider, a tangible indicator that regulators moved beyond citation into financial consequence. Staffing is reported at 4.20 total nursing hours per resident day (national average 3.89), with RN coverage at 0.50 per resident day — the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature.
Classified as "For profit - Corporation" ownership and operating as a "Medicare and Medicaid" provider, Great Oaks Rehabilitation and Healthcare Center falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes — ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 60.7%, above the level where continuity of care typically begins to suffer. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report — the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.
Deficiency History (24 most recent)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Dec 26, 2025
Respond appropriately to all alleged violations.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Dec 26, 2025
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Dec 26, 2025
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Category: Resident Rights Deficiencies
Corrected: Dec 26, 2025
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 21, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 21, 2025
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jul 21, 2025
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Category: Resident Rights Deficiencies
Corrected: Jul 21, 2025
Reasonably accommodate the needs and preferences of each resident.
Category: Resident Rights Deficiencies
Corrected: Jul 21, 2025
Ensure that residents are fully informed and understand their health status, care and treatments.
Category: Resident Rights Deficiencies
Corrected: Jul 21, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Jun 11, 2025
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Category: Nursing and Physician Services Deficiencies
Corrected: Nov 7, 2024
Protect each resident from the wrongful use of the resident's belongings or money.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Nov 7, 2024
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Category: Resident Rights Deficiencies
Corrected: Jun 14, 2024
Provide care and assistance to perform activities of daily living for any resident who is unable.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 2, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 2, 2024
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Feb 2, 2024
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.
Category: Pharmacy Service Deficiencies
Corrected: Feb 2, 2024
Ensure services provided by the nursing facility meet professional standards of quality.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 2, 2024
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 2, 2024
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Category: Resident Rights Deficiencies
Corrected: Feb 2, 2024
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Dec 29, 2022
Provide safe and appropriate respiratory care for a resident when needed.
Category: Quality of Life and Care Deficiencies
Corrected: Dec 29, 2022
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Dec 29, 2022
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 21.2% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 4.1% | No |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 1.6% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 1.7% | Yes |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 0.0% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 0.8% | Yes |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 100.0% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 100.0% | No |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 4.1% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 37.9% | Yes |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 47.1% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 97.1% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | 98.7% | No |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 10.3% | Yes |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 21.2% | No |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 12.9% | Yes |
Penalty History 1 penalties totaling $14K
| Date | Type | Amount |
|---|---|---|
| May 22, 2025 | Fine | $14K |
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Understanding Nursing Home Data
Frequently Asked Questions
What is the overall CMS rating for Great Oaks Rehabilitation and Healthcare Center?
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Does Great Oaks Rehabilitation and Healthcare Center have any deficiencies on record?
Has Great Oaks Rehabilitation and Healthcare Center received any fines or penalties?
Who owns Great Oaks Rehabilitation and Healthcare Center?
When was Great Oaks Rehabilitation and Healthcare Center last inspected?
What quality measures are tracked for Great Oaks Rehabilitation and Healthcare Center?
Data Sources
Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.
Read our methodology — how this data is sourced, computed, and verified.