Countryside Care Center - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
235574
Provider Name
COUNTRYSIDE CARE CENTER
Provider Address
2121 ROBINSON RD
JACKSON, MI 49203
JACKSON, MI 49203
Provider Phone Number
5177874150
Provider SSA County
370
Provider County Name
Jackson
Ownership Type
For profit - Individual
Number of Certified Beds
108
Number of Residents in Certified Beds
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRYSIDE CARE CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-03-01
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
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.72475
Reported LPN Staffing Hours per Resident per Day
0.71818
Reported RN Staffing Hours per Resident per Day
0.65303
Reported Licensed Staffing Hours per Resident per Day
1.37121
Reported Total Nurse Staffing Hours per Resident per Day
4.09596
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11364
Expected CNA Staffing Hours per Resident per Day
2.53126
Expected LPN Staffing Hours per Resident per Day
0.58911
Expected RN Staffing Hours per Resident per Day
0.93620
Expected Total Nurse Staffing Hours per Resident per Day
4.05657
Adjusted CNA Staffing Hours per Resident per Day
2.64126
Adjusted LPN Staffing Hours per Resident per Day
1.01186
Adjusted RN Staffing Hours per Resident per Day
0.52120
Adjusted Total Nurse Staffing Hours per Resident per Day
4.07004
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2014-09-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-11-15
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
44
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
124.00000
Number of Facility Reported Incidents
15
Number of Substantiated Complaints
15
Number of Fines
2
Total Amount of Fines in Dollars
1788
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Ridgecrest Health Campus
703 Robinson Rd |
JACKSON MI 49203 | 0.3 mile away
Jackson County Medical Care Facility
524 Lansing Ave |
JACKSON MI 49201 | 2.8 miles away
Faith Haven Senior Care Centre
6531 W Michigan Avenue |
JACKSON MI 49201 | 2.9 miles away
Heartland Health Care Center-jackson
434 W North St |
JACKSON MI 49202 | 3 miles away
Vista Grande Villa
2251 Springport Rd |
JACKSON MI 49202 | 3.2 miles away
Arbor Manor Care Center
151 2nd St |
SPRING ARBOR MI 49283 | 4.9 miles away
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