Countryside Health Center - Topeka Nursing Home
General Information
UPDATEFederal Provider Number
17E528
Provider Name
COUNTRYSIDE HEALTH CENTER
Provider Address
440 SE WOODLAND AVE
TOPEKA, KS 66607
TOPEKA, KS 66607
Provider Phone Number
(785) 234-6147
Provider SSA County
880
Provider County Name
Shawnee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
68
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1982-12-06
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
2.12206
Reported LPN Staffing Hours per Resident per Day
0.35294
Reported RN Staffing Hours per Resident per Day
0.80662
Reported Licensed Staffing Hours per Resident per Day
1.15956
Reported Total Nurse Staffing Hours per Resident per Day
3.28162
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.56786
Expected LPN Staffing Hours per Resident per Day
0.51255
Expected RN Staffing Hours per Resident per Day
0.71005
Expected Total Nurse Staffing Hours per Resident per Day
2.79046
Adjusted CNA Staffing Hours per Resident per Day
3.32103
Adjusted LPN Staffing Hours per Resident per Day
0.57153
Adjusted RN Staffing Hours per Resident per Day
0.84882
Adjusted Total Nurse Staffing Hours per Resident per Day
4.74039
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-09-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-05-29
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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