Countryside Home

Total Number of Beds: 69	Percent of Occupied Beds: 91%
Total Number of Residents: 63	Located Within a Hospital: No
Type of Ownership: Government - City	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 09/18/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.73

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.83

Number of CNA Hours per Nursing Home Resident per Day: 3.53

Number of Staff Hours per Nursing Home Resident per Day: 5.09

Nursing Home Resident Information**:

Percent of High-Risk Residents Who Have Pressure Sores: 3%
Percent of Residents Who Have Moderate to Severe Pain: 10%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 22%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 2%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 20%
Percent of Residents Who are More Depressed or Anxious: 37%
Percent of Residents Who Were Physically Restrained: 2%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 44%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 4%
Percent of Residents With a Urinary Tract Infection: 5%
** Details Last Reported on: 9/18/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-07-09	2001-08-22	Quality Care Deficiencies	Provide social services for related medical problems to help each resident achieve the highest possible quality of life.	Isolated	Minimal harm or potential for actual harm
2001-07-09	2001-07-09	Environmental Deficiencies	Make sure that the nursing home area is free of dangers that cause accidents.	Widespread	Potential for minimal harm
2001-07-09	2001-08-22	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
2003-09-18	2003-10-31	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

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