Ohio Nursing Homes >> Fremont Nursing Homes >> Countryside Continuing Care Ct

Countryside Continuing Care Ct - Fremont Nursing Home

General Information

UPDATE
Federal Provider Number
365418
Provider Name
COUNTRYSIDE CONTINUING CARE CT
Provider Address
1865 COUNTRYSIDE DRIVE
FREMONT, OH 43420
Provider Phone Number
(419) 334-2602
Provider SSA County
730
Provider County Name
Sandusky
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY NURSING CENTER OF FREMONT, INC
Date First Approved to Provide Medicare and Medicaid services
1979-05-29
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.02000
Reported LPN Staffing Hours per Resident per Day
0.53867
Reported RN Staffing Hours per Resident per Day
0.56067
Reported Licensed Staffing Hours per Resident per Day
1.09933
Reported Total Nurse Staffing Hours per Resident per Day
3.11934
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04000
Expected CNA Staffing Hours per Resident per Day
2.33062
Expected LPN Staffing Hours per Resident per Day
0.69492
Expected RN Staffing Hours per Resident per Day
1.28429
Expected Total Nurse Staffing Hours per Resident per Day
4.30983
Adjusted CNA Staffing Hours per Resident per Day
2.12668
Adjusted LPN Staffing Hours per Resident per Day
0.64338
Adjusted RN Staffing Hours per Resident per Day
0.32620
Adjusted Total Nurse Staffing Hours per Resident per Day
2.91746
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2012-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
2011-09-01
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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
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