Countryside Health Center

Total Number of Beds: 62	Percent of Occupied Beds: 92%
Total Number of Residents: 57	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: 05/28/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.42

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.63

Number of CNA Hours per Nursing Home Resident per Day: 1.93

Number of Staff Hours per Nursing Home Resident per Day: 2.98

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 16%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 3%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 12%
Percent of Residents Who are More Depressed or Anxious: 9%
Percent of Residents Who Were Physically Restrained: 40%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 11%
** Details Last Reported on: 5/28/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-06	2001-07-19	Quality Care Deficiencies	Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Resident Rights Deficiencies	Provide services to meet the needs and preferences of each resident.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	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
2003-05-28	2003-07-18	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Pattern	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Nutrition and Dietary Deficiencies	Provide food in a way that meets a resident's needs.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Widespread	Potential for minimal harm
2003-05-28	2003-07-18	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2003-05-28	2003-07-18	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm

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