Countryside Nursing Center

Total Number of Beds: 101	Percent of Occupied Beds: 97%
Total Number of Residents: 98	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: 08/01/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day: 0.24

Number of LPN/LVN Hours per Nursing Home Resident per Day: 0.77

Number of CNA Hours per Nursing Home Resident per Day: 1.99

Number of Staff Hours per Nursing Home Resident per Day: 3

Nursing Home Resident Information**:

Percent of Low-Risk Residents Who Have Pressure Sores: 0%
Percent of Short-Stay Residents With Pressure Sores: 8%
Percent of High-Risk Residents Who Have Pressure Sores: 8%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain: 36%
Percent of Residents Who Have Moderate to Severe Pain: 3%
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse: 12%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 4%
Percent of Residents Whose Need for Help With Daily Activities Has Increased: 9%
Percent of Residents Who are More Depressed or Anxious: 9%
Percent of Short-Stay Residents With Delirium: 0%
Percent of Residents Who Were Physically Restrained: 0%
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder: 31%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 2%
Percent of Residents With a Urinary Tract Infection: 5%
** Details Last Reported on: 8/1/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-09-14	2001-10-15	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2001-09-14	2001-10-15	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2001-09-14	2001-10-15	Resident Assessment Deficiencies	Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home.	Pattern	Potential for minimal harm
2001-09-14	2001-10-15	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.	Pattern	Minimal harm or potential for actual harm
2001-09-14	2001-10-15	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
2002-08-16	2002-09-03	Resident Rights Deficiencies	Have a private telephone available for use.	Pattern	Potential for minimal harm
2002-08-16	2002-09-03	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Minimal harm or potential for actual harm
2003-08-01	2003-09-15	Resident Rights Deficiencies	Keep each resident's personal and medical records private and confidential.	Pattern	Potential for minimal harm
2003-08-01	2003-09-15	Resident Rights Deficiencies	Provide care in a way that keeps or builds each resident's dignity and self respect.	Pattern	Potential for minimal harm
2003-08-01	2003-09-15	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2003-08-01	2003-09-15	Quality Care Deficiencies	Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	Isolated	Minimal harm or potential for actual harm
2003-08-01	2003-09-15	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
2003-08-01	2003-09-15	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2003-08-01	2003-09-15	Administration Deficiencies	Train all employees on what to do in an emergency.	Widespread	Potential for minimal harm

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