Countryside Care & Rehabilitation - Rupert Nursing Home
General Information
UPDATEFederal Provider Number
135064
Provider Name
COUNTRYSIDE CARE & REHABILITATION
Provider Address
1224 EIGHTH STREET
RUPERT, ID 83350
RUPERT, ID 83350
Provider Phone Number
(208) 436-0481
Provider SSA County
330
Provider County Name
Minidoka
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
46
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
MINIDOKA MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1976-12-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.25610
Reported LPN Staffing Hours per Resident per Day
1.23780
Reported RN Staffing Hours per Resident per Day
0.82317
Reported Licensed Staffing Hours per Resident per Day
2.06098
Reported Total Nurse Staffing Hours per Resident per Day
6.31707
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03537
Expected CNA Staffing Hours per Resident per Day
2.39003
Expected LPN Staffing Hours per Resident per Day
0.54840
Expected RN Staffing Hours per Resident per Day
0.73024
Expected Total Nurse Staffing Hours per Resident per Day
3.66867
Adjusted CNA Staffing Hours per Resident per Day
4.36948
Adjusted LPN Staffing Hours per Resident per Day
1.87339
Adjusted RN Staffing Hours per Resident per Day
0.84229
Adjusted Total Nurse Staffing Hours per Resident per Day
6.94079
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-11-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
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
28
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-05-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
975
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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