Belmont Lodge Health Care Center - Pueblo Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
65169
Provider Name
BELMONT LODGE HEALTH CARE CENTER
Provider Address
1601 CONSTITUTION ROAD
PUEBLO, CO 81001
PUEBLO, CO 81001
Provider Phone Number
(719) 562-7200
Provider SSA County
500
Provider County Name
Pueblo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
80
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC PUEBLO BELMONT OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1982-07-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.97500
Reported LPN Staffing Hours per Resident per Day
0.48125
Reported RN Staffing Hours per Resident per Day
0.76063
Reported Licensed Staffing Hours per Resident per Day
1.24188
Reported Total Nurse Staffing Hours per Resident per Day
3.21688
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01938
Expected CNA Staffing Hours per Resident per Day
2.17887
Expected LPN Staffing Hours per Resident per Day
0.62336
Expected RN Staffing Hours per Resident per Day
1.06386
Expected Total Nurse Staffing Hours per Resident per Day
3.86609
Adjusted CNA Staffing Hours per Resident per Day
2.22411
Adjusted LPN Staffing Hours per Resident per Day
0.64078
Adjusted RN Staffing Hours per Resident per Day
0.53423
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35402
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
172
Cycle 1 Standard Survey Health Date
2014-10-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
172
Cycle 2 Total Number of Health Deficiencies
23
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
176
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
88
Cycle 2 Total Health Score
264
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
190.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
Number of Fines
5
Total Amount of Fines in Dollars
55760
Number of Payment Denials
2
Total Number of Penalties
7
Location
Processing Date
2015-06-01
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