Countryside Meadows - Avon Nursing Home
General Information
UPDATEFederal Provider Number
155792
Provider Name
COUNTRYSIDE MEADOWS
Provider Address
762 N DAN JONES RD
AVON, IN 46123
AVON, IN 46123
Provider Phone Number
3174957200
Provider SSA County
310
Provider County Name
Hendricks
Ownership Type
Government - County
Number of Certified Beds
171
Number of Residents in Certified Beds
141
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Date First Approved to Provide Medicare and Medicaid services
2011-07-11
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.48830
Reported LPN Staffing Hours per Resident per Day
1.14929
Reported RN Staffing Hours per Resident per Day
1.38936
Reported Licensed Staffing Hours per Resident per Day
2.53865
Reported Total Nurse Staffing Hours per Resident per Day
5.02695
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11667
Expected CNA Staffing Hours per Resident per Day
2.86677
Expected LPN Staffing Hours per Resident per Day
0.89887
Expected RN Staffing Hours per Resident per Day
1.43937
Expected Total Nurse Staffing Hours per Resident per Day
5.20501
Adjusted CNA Staffing Hours per Resident per Day
2.12976
Adjusted LPN Staffing Hours per Resident per Day
1.06124
Adjusted RN Staffing Hours per Resident per Day
0.72124
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89301
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-10-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2013-09-27
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
10
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
70.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
22
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
Brooke Knoll Village
1108 Kingwood Drive |
AVON IN 46123 | 1.8 miles away
Manorcare Health Services - Prestwick
445 S Cr 525 E |
AVON IN 46123 | 2.9 miles away
Brownsburg Health Care Center
1010 Hornaday Rd |
BROWNSBURG IN 46112 | 3.9 miles away
Avon Health & Rehabilitation Ctr
4171 Forest Pointe Cir |
AVON IN 46123 | 3.9 miles away
Brownsburg Meadows
2 E Tilden |
BROWNSBURG IN 46112 | 4.4 miles away
Plainfield Health Care Center
3700 Clarks Creek Rd |
PLAINFIELD IN 46168 | 4.5 miles away
Danville Regional Rehabilitation
255 Meadow Dr |
DANVILLE IN 46122 | 6.2 miles away
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