Columbine West Health And Rehab Facility - Fort Collins Nursing Home

General Information

UPDATE
Federal Provider Number
65245
Provider Name
COLUMBINE WEST HEALTH AND REHAB FACILITY
Provider Address
940 WORTHINGTON CIRCLE
FORT COLLINS, CO 80526
Provider Phone Number
9702212273
Provider SSA County
340
Provider County Name
Larimer
Ownership Type
For profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLUMBINE CARE CENTER WEST INC.
Date First Approved to Provide Medicare and Medicaid services
1988-12-20
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.83636
Reported LPN Staffing Hours per Resident per Day
0.30152
Reported RN Staffing Hours per Resident per Day
1.27576
Reported Licensed Staffing Hours per Resident per Day
1.57727
Reported Total Nurse Staffing Hours per Resident per Day
4.41364
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11111
Expected CNA Staffing Hours per Resident per Day
2.47593
Expected LPN Staffing Hours per Resident per Day
0.58637
Expected RN Staffing Hours per Resident per Day
0.87472
Expected Total Nurse Staffing Hours per Resident per Day
3.93701
Adjusted CNA Staffing Hours per Resident per Day
2.81089
Adjusted LPN Staffing Hours per Resident per Day
0.42680
Adjusted RN Staffing Hours per Resident per Day
1.08978
Adjusted Total Nurse Staffing Hours per Resident per Day
4.51889
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-01-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-02-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-02-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
53.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
2
Total Amount of Fines in Dollars
4680
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01

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