Countryside Estates
Countryside Estates Information
| Facility Name | Countryside Estates |
| Location | Highway 64 East, Warner, OK 74469 |
| County (SSA Code) | Muskogee (500) |
| Phone Number | 918-463-5143 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 111 |
| Average Number of Residents | 74.9 |
| 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 HEALTH SERVICES LLC |
| Ownership Type | For profit - Partnership |
| Date First Approved | 1998-07-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 3.45321 |
| Reported LPN Staffing Hours per Resident per Day | 1.76416 |
| Reported RN Staffing - Hours per Resident per Day | 0.11096 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.87512 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 5.32832 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.00308 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.19148 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.82632 |
| Case-Mix RN Staffing - Hours per Resident per Day | 1.15052 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.16832 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.07543 |
| Total Weighted Health Survey Score for three cycles | 157.5 |
| Rating cycle 1 Standard Survey Health Date | 2020-01-09 |
| Rating cycle 1 - Total Health Inspection Score | 386 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-11-29 |
| Rating cycle 2 - Health Deficiency Score | 386 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-09-05 |
| Rating cycle 3 - Health Deficiency Score | 173 |
| Rating cycle 3 - Total Health Inspection Score | 173 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 3 |
| Number of Substantiated Complaints | 3 |
| Number of Fines | 1 |
| Total Amount of Fines (in Dollars) | 272572 |
| Number of Payment Denials | 1 |
| Total Number of Penalties | 2 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |