Countryside Health Care Center

Total Number of Beds: 43	Percent of Occupied Beds: 98%
Total Number of Residents: 42	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 02/20/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.43

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.35

Number of CNA Hours per Nursing Home Resident per Day: 3.16

Number of Staff Hours per Nursing Home Resident per Day: 3.94

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 7%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 15%
Percent of Residents Who are More Depressed or Anxious: 28%
Percent of Residents Who Were Physically Restrained: 12%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 11%
Percent of Residents With a Urinary Tract Infection: 7%
** Details Last Reported on: 2/20/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-01-17	2001-02-02	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-01-17	2001-02-23	Resident Assessment Deficiencies	Do a new assessment after any major change in a resident's physical or mental health.	Isolated	Minimal harm or potential for actual harm
2001-01-17	2001-02-23	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Widespread	Potential for minimal harm
2001-01-17	2001-02-23	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Isolated	Minimal harm or potential for actual harm
2001-01-17	2001-02-23	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Isolated	Minimal harm or potential for actual harm
2002-03-27	2002-04-12	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Isolated	Minimal harm or potential for actual harm
2003-02-20	2003-03-12	Environmental Deficiencies	Get rid of garbage properly.	Widespread	Potential for minimal harm

*** All violations listed are based on federal government records.