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NATIONAL NURSING HOME WATCH LIST

COUNTRYSIDE MANOR HEALTH & LIVING COMM: Actual Harm and/or Immediate Jeopardy

205 MARINE DRIVE

ANDERSON IN

TELEPHONE: 7656494558

TYPE OF OWNERSHIP: For profit - Corporation

NUMBER OF BEDS / PERCENT OCCUPIED: 109 / 82

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Based on the annual and complaint survey data reported by CMS as of 02/06/10 , this home is listed because in at least one area they caused actual harm to a patient and/or subjected the patients to immediate jeopardy. More recent reports/corrections may be available. Check with the nursing home administrator. Actual harm is indicated by a score of G, H, I, while J, K, L indicate immediate jeopardy. The color coding scheme is below:
RATING DEFINITION
actual harm and/or immediate jeopardy: score= G,H,I,J,K,L
potential for more than minimal harm: score= D, E, F
potential for minimal harm: score= A, B, C
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NOTE: THIS HOME ALSO FOUND TO HAVE CAUSED ACTUAL HARM OR PLACED
PATIENTS IN IMMEDIATE JEOPARDY ON AT LEAST: 2 ADDITIONAL SURVEY(S)
RESULTS LISTED BASED ON MOST RECENT ANNUAL SURVEY DATED: 06/18/2009
RATING VIOLATION SCOPE/SEVERITY CODE
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. D
Make sure that residents are well nourished. E
Make sure that the nursing home area is free of dangers that cause accidents. D
Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or d D
Properly mark drugs and other similar products. E
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. G
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. D
Have a program to keep infection from spreading. E
Store, cook, and give out food in a safe and clean way. E
Give professional services that follow each resident's written care plan. D
Provide care in a way that keeps or builds each resident's dignity and self respect. D

COMPLAINT SURVEY RESULTS: SUBSTANTIATED

DATERATINGCOMPLAINT VIOLATION CONFIRMEDSCOPE/SEVERITY CODE
11/17/2006 Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transf D
11/17/2006 Make sure that the nursing home area is free of dangers that cause accidents. D
11/17/2006 Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. E
02/01/2007 Provide social services for related medical problems to help each resident achieve the highest possible quality of life. D
02/01/2007 Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. D
02/01/2007 1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects. D
02/01/2007 Properly mark drugs and other similar products. D
02/19/2007 Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. D
02/19/2007 Give professional services that meet a professional standard of quality. D
02/19/2007 Get services outside the nursing home that meet professional standards. D
02/19/2007 Keep accurate and appropriate medical records. D
10/02/2007 1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day. E
11/05/2007 Make sure that the nursing home area is free of dangers that cause accidents. D
01/23/2008 Make a complete assessment that covers all questions for areas that are listed in official regulations. G
01/23/2008 Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. D
01/23/2008 1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects. G
01/23/2008 Keep accurate and appropriate medical records. D
06/17/2008 Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. D
06/17/2008 Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. D
06/17/2008 Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. D
08/14/2008 Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transf D
08/14/2008 Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. D
08/14/2008 Have a program to keep infection from spreading. D
02/06/2009 Provide services to meet the needs and preferences of each resident. E
02/06/2009 Give professional services that follow each resident's written care plan. E
07/29/2009 Give professional services that follow each resident's written care plan. D
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