Countryside Place Nursing & Rehab

Total Number of Beds: 87	Percent of Occupied Beds: 89%
Total Number of Residents: 77	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: 03/31/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.72

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.46

Number of CNA Hours per Nursing Home Resident per Day: 1.84

Number of Staff Hours per Nursing Home Resident per Day: 3.02

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 0%
Percent of Short-Stay Residents With Pressure Sores: 16%
Percent of High-Risk Residents Who Have Pressure Sores: 4%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 11%
Percent of Residents Who Have Moderate to Severe Pain: 2%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 11%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 0%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 17%
Percent of Residents Who are More Depressed or Anxious: 14%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 1%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 48%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 6%
Percent of Residents With a Urinary Tract Infection: 4%
** Details Last Reported on: 3/31/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-02-23	2001-03-01	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Isolated	Minimal harm or potential for actual harm
2001-02-23	2001-02-26	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2001-02-23	2001-03-08	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Isolated	Minimal harm or potential for actual harm
2001-02-23	2001-03-25	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Widespread	Potential for minimal harm
2001-02-23	2001-03-25	Administration Deficiencies	Hire nurse aides who have completed required training and shown that they are skilled.	Pattern	Potential for minimal harm
2001-02-23	2001-03-25	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Pattern	Potential for minimal harm
2002-01-11	2002-02-04	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Minimal harm or potential for actual harm
2002-01-11	2002-02-04	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Isolated	Minimal harm or potential for actual harm
2002-01-11	2002-02-04	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Minimal harm or potential for actual harm
2002-01-11	2002-02-04	Pharmacy Service Deficiencies	Act when the pharmacist reports something unusual.	Isolated	Minimal harm or potential for actual harm
2002-01-11	2002-02-04	Administration Deficiencies	Make sure that nurse aides show they have the skills to be able to care for residents.	Isolated	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	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
2003-03-31	2003-04-30	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Pattern	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Quality Care Deficiencies	Give professional services that meet a professional standard of quality.	Isolated	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Quality Care Deficiencies	Make sure that each resident gets help to keep vision and hearing.	Isolated	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Pharmacy Service Deficiencies	Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	Pattern	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Pharmacy Service Deficiencies	Properly mark drugs and other similar products.	Pattern	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Environmental Deficiencies	Have a program to keep infection from spreading.	Isolated	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Minimal harm or potential for actual harm
2003-03-31	2003-04-30	Administration Deficiencies	Hold committee meetings every 3 months to review and ensure quality in the nursing home.	Widespread	Potential for minimal harm

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