Countryside Estates - Warner Nursing Home
General Information
UPDATEFederal Provider Number
375341
Provider Name
COUNTRYSIDE ESTATES
Provider Address
HIGHWAY 64 EAST
WARNER, OK 74469
WARNER, OK 74469
Provider Phone Number
9184635143
Provider SSA County
500
Provider County Name
Muskogee
Ownership Type
For profit - Corporation
Number of Certified Beds
111
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRYSIDE HEALTH SERVICES LLC
Date First Approved to Provide Medicare and Medicaid services
1998-07-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.71839
Reported LPN Staffing Hours per Resident per Day
1.24310
Reported RN Staffing Hours per Resident per Day
0.17126
Reported Licensed Staffing Hours per Resident per Day
1.41437
Reported Total Nurse Staffing Hours per Resident per Day
4.13275
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01667
Expected CNA Staffing Hours per Resident per Day
2.49730
Expected LPN Staffing Hours per Resident per Day
0.97099
Expected RN Staffing Hours per Resident per Day
1.33223
Expected Total Nurse Staffing Hours per Resident per Day
4.80052
Adjusted CNA Staffing Hours per Resident per Day
2.67093
Adjusted LPN Staffing Hours per Resident per Day
1.06260
Adjusted RN Staffing Hours per Resident per Day
0.09605
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47018
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-02-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
196
Cycle 2 Standard Health Survey Date
2013-04-11
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
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-01-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
122.66700
Number of Facility Reported Incidents
1
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
Nursiong Homes Nearby
Pleasant Valley Health Care Center
1120 Illinois |
MUSKOGEE OK 74403 | 16.7 miles away
York Manor Nursing Home
500 South York |
MUSKOGEE OK 74403 | 17 miles away
Broadway Manor Nursing Home
1622 East Broadway |
MUSKOGEE OK 74403 | 17.5 miles away
Eastgate Village Retirement Center
3500 Haskell Blvd |
MUSKOGEE OK 74403 | 17.8 miles away
Muskogee Nursing Center
602 North M Street |
MUSKOGEE OK 74403 | 17.9 miles away
Grace Living Center-muskogee
4717 West Okmulgee |
MUSKOGEE OK 74401 | 19.4 miles away
Brentwood Extended Care & Rehab
841 North 38th Street |
MUSKOGEE OK 74401 | 19.6 miles away
Fort Gibson Nursing Home
205 East Poplar |
FORT GIBSON OK 74434 | 21.3 miles away
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