Countryside Nursing Home Inc - Framingham Nursing Home
General Information
UPDATEFederal Provider Number
22E522
Provider Name
COUNTRYSIDE NURSING HOME INC
Provider Address
153 WINTER STREET
FRAMINGHAM, MA 1701
FRAMINGHAM, MA 1701
Provider Phone Number
(508) 872-5250
Provider SSA County
90
Provider County Name
Middlesex
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
29
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
1974-03-31
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.38448
Reported LPN Staffing Hours per Resident per Day
0.28448
Reported RN Staffing Hours per Resident per Day
0.73448
Reported Licensed Staffing Hours per Resident per Day
1.01897
Reported Total Nurse Staffing Hours per Resident per Day
3.40344
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.44204
Expected LPN Staffing Hours per Resident per Day
0.52667
Expected RN Staffing Hours per Resident per Day
0.69926
Expected Total Nurse Staffing Hours per Resident per Day
3.66796
Adjusted CNA Staffing Hours per Resident per Day
2.39587
Adjusted LPN Staffing Hours per Resident per Day
0.44833
Adjusted RN Staffing Hours per Resident per Day
0.78484
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74020
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-09-16
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
8
Cycle 3 Standard Health Survey Date
2012-09-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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