COUNTRYSIDE MANOR INC - BRISTOL, CT
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Back to Hospital Data. Institution representatives - add corrected or new information about COUNTRYSIDE MANOR INC » COUNTRYSIDE MANOR INC1660 STAFFORD AVENUE BRISTOL, CT 06010 RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DUALLY CERTIFIED) Services provided by COUNTRYSIDE MANOR INC:
Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 90 Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 90 Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 4.39 Change of ownership counter (The number of times a change of ownership (chow) has taken place for a particular provider): 3 Change of ownership date (Effective date of a change of ownership): Feb 1998 Program participation (Indicates if the provider participates in Medicare, Medicaid, or both programs): MEDICARE AND MEDICAID Regional override #2 (staffing) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes Activity professional - Full time (The number of full-time equivalent activities professionals employed full time by a facility): 1.39 Administrator - Full time (The number of full-time equivalent administrative staff employed on a full time basis by a facility): 1.14 Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 90 Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 22.63 Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 13.50 Dentists - Contract (The number of full-time equivalent dentists under contract to a facility): 0.06 Dietitians - Contract (The number of full-time equivalent under contract to a facility): 0.23 Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 5.33 Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 5.44 Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 6.83 Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 3.47 Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 8.80 Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.04 Mental health services - Contract (The number of full-time equivalent mental health services personnel under contract to a facility): 0.17 Multi-Facility organization name (The name of the multi-Facility organization that owns the facility): COLUMBIA PACIFIC MANAGEMENT, INC. Multi-Facility organization owned (Indicates if a facility is owned by an organization that owns (or leases) two or more nursing facilities): Yes Nurses with admin duties-Full time (The number of full-time equivalent nurses with administrative duties employed by a facility on a full time basis): 1.49 Nurses with admin duties-Part time (Number of full-time equivalent nurses with administrative duties employed by a facility on a part time basis): 1.53 Occup therapy asst - Contract (The number of full time equivalent occupational therapy assistants under contrcat to a facility): 0.91 Organized resident group (Indicates if the facility has an organized residents group): Yes Other - Full time (The number of full-time equivalent persons not included in any other categories employed by the facility on a full-time basis): 4.40 Other - Part time (The number of full-time equivalent persons not included in any other categories employed by the facility on a part-time basis): 1.06 Other physician - Contract (The number of full-time equivalent other physicians under contract to a facility): 0.04 Othr social serv staff-Full time (Number of full-time staff hours provided by other socia l services staff): 1.14 Pharmacists - Contract (The number of full-time equivalent pharmacists under contract to a facility): 0.14 Physical therapists - Contract (The number of full-time equivalent physical therapists under contract to a facility): 1.14 Podiatrists - Contract (The number of full time equivalent podiatrists under contract to a facility): 0.06 Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 6.50 Rn director of nursing - Full time (The number of full-time equivalent rn director of nursing employed by a facility on a full time basis): 1.14 Social worker - Contract (The number of full-time equivalent social workers under contract to a facility): 0.11 Special care beds-Alzheimers (The number of beds in a unit identified and dedicated by the facility for residents with alzeheimers): 16 Speech pathologist - Contract (The number of full-time equivalent speech pathologists under contract to a facility): 0.07 Ther rec spec - Full time (Number of full-time staff hours provided by therapeutic recreation specialist): 1.14 Compliance: plan of correction (Indicates if a provider is in compliance with program requirements based on an acceptable plan for correction of deficiencies): COMPLIANCE BASED ON ACCEPTABLE POC Compliance: status (Indicates if a provider or supplier is in compliance with program requirements): IN COMPLIANCE Current survey date (The date of the health or life safety code survey, whichever is later. the "official" survey date for the provider): Jun 1997 Eligibility code (Indicates if a facility is eligible to participate in the Medicare and/or Medicaid programs): ELIGIBLE TO PARTICIPATE Participation date (The date a facility is first approved to provide Medicare and/or Medicaid services): Mar 1994 |
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