Countryside Home - JEFFERSON, OR - Nursing Home Abuse and Neglect Report  
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General Information
Category: Participating in Medicare and Medicaid
COUNTRYSIDE HOME
(920) 674-3170
1130 COLLINS ROAD
JEFFERSON, WI 53549
Last inspected: 07/14/05
Certified Bed Count: 120
Total Residents: 119
Occupancy: 99%
Ownership: Government - County
Inside Hospital: NO
Resident Nurse: 0.67
LPN/LVN Care: 0.71
C.N.A. Care: 3.28
Total Staff: 0
Total Licensed Staff: 0
(All hours are per Resident per Day)
Resident Survey
Measure Score County Ave State Ave Updated
Percent of High-Risk Residents Who Have Pressure Sores 16 %     07/14/05
Percent of Low-Risk Residents Who Have Pressure Sores 2 %     07/14/05
Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder 55 %     07/14/05
Percent of Residents Who are More Depressed or Anxious 17 %     07/14/05
Percent of Residents Who Have Moderate to Severe Pain 9 %     07/14/05
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder 7 %     07/14/05
Percent of Residents Who Lose Too Much Weight 6 %     07/14/05
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair 0 %     07/14/05
Percent of Residents Who Were Physically Restrained 1 %     07/14/05
Percent of Residents Whose Ability to Move About in and Around Their Room Got Worse 11 %     07/14/05
Percent of Residents Whose Need for Help With Daily Activities Has Increased 15 %     07/14/05
Percent of Residents With a Urinary Tract Infection 7 %     07/14/05
Percent of Short-Stay Residents Who Had Moderate to Severe Pain 36 %     07/14/05
Percent of Short-Stay Residents With Delirium 0 %     07/14/05
Percent of Short-Stay Residents With Pressure Sores 12 %     07/14/05

Countryside Home - Nursing Home Treatment Deficiencies

Severity Scope Level of Nursing Home Neglect Updated
Category Deficiency
 
Isolated Minimal harm or potential for actual harm 07/15/03
Quality Care Deficiencies Give each resident care and services to get or keep the highest quality of life possible.

Countryside Home - Nursing Home Inspections - Nursing Home Abuse Report

No inspection results have been reported.
Medicare Suppliers in JEFFERSON
Out of 3
MUELLER DRUGS INC
Pharmacy/Drug Store
(920)674-5733
132 S MAIN ST
JEFFERSON, WI 53549
ST MARYS DEAN VENTURES INC
Optometry/Optician
(920)674-2217
144 W GARLAND ST
JEFFERSON, WI 53549
MOBILITY MASTERS LLC
Durable Medical Equipment
(920)674-5499
823 LUCAS LN
JEFFERSON, WI 53549
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