Countryside Home
Countryside Home Information
| Facility Name | Countryside Home |
| Location | 703 North Main Street, Madison, NE 68748 |
| County (SSA Code) | Madison (590) |
| Phone Number | 402-454-3373 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 70 |
| Average Number of Residents | 56.4 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | COUNTRYSIDE HOME |
| Ownership Type | Government - City |
| Date First Approved | 1997-04-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 3.28464 |
| Reported LPN Staffing Hours per Resident per Day | 0.60263 |
| Reported RN Staffing - Hours per Resident per Day | 0.79576 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.39839 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.68304 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.05345 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.10488 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.6843 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.29502 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.0842 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.84093 |
| Total Weighted Health Survey Score for three cycles | 22.667 |
| Rating cycle 1 Standard Survey Health Date | 2019-11-13 |
| Rating cycle 1 - Health Deficiency Score | 3 |
| Rating cycle 1 - Total Health Inspection Score | 36 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-10-09 |
| Rating cycle 2 - Health Deficiency Score | 36 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-07-17 |
| Rating cycle 3 - Health Deficiency Score | 16 |
| Rating cycle 3 - Total Health Inspection Score | 16 |
| Number of Facility-Reported Incidents | 2 |
| Number of Substantiated Complaints | 1 |
| Number of Substantiated Complaints | 1 |
| Number of Payment Denials | 1 |
| Total Number of Penalties | 1 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |