Alden Estates Of Countryside, Inc - Jefferson Nursing Home
General Information
UPDATEFederal Provider Number
525271
Provider Name
ALDEN ESTATES OF COUNTRYSIDE, INC
Provider Address
1130 COLLINS ROAD
JEFFERSON, WI 53549
JEFFERSON, WI 53549
Provider Phone Number
9206743170
Provider SSA County
270
Provider County Name
Jefferson
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
112
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ALDEN ESTATES OF COUNTRYSIDE, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-03-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.91250
Reported LPN Staffing Hours per Resident per Day
0.79018
Reported RN Staffing Hours per Resident per Day
0.66786
Reported Licensed Staffing Hours per Resident per Day
1.45804
Reported Total Nurse Staffing Hours per Resident per Day
3.37054
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14464
Expected CNA Staffing Hours per Resident per Day
2.43261
Expected LPN Staffing Hours per Resident per Day
0.58051
Expected RN Staffing Hours per Resident per Day
0.93538
Expected Total Nurse Staffing Hours per Resident per Day
3.94849
Adjusted CNA Staffing Hours per Resident per Day
1.92908
Adjusted LPN Staffing Hours per Resident per Day
1.12978
Adjusted RN Staffing Hours per Resident per Day
0.53350
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44088
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-05-29
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
58.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Golden Livingcenter-fort Atkinson
430 Wilcox St |
FORT ATKINSON WI 53538 | 4.1 miles away
Willowbrook Nursing And Rehab
901 Mulberry St |
LAKE MILLS WI 53551 | 7.4 miles away
Golden Livingcenter-watertown
121 Hospital Dr |
WATERTOWN WI 53098 | 15.5 miles away
Marquardt Memorial Manor
1020 Hill St |
WATERTOWN WI 53098 | 15.6 miles away
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