Boulder Manor - Boulder Nursing Home
General Information
UPDATEFederal Provider Number
65222
Provider Name
BOULDER MANOR
Provider Address
4685 EAST BASELINE ROAD
BOULDER, CO 80303
BOULDER, CO 80303
Provider Phone Number
3034940535
Provider SSA County
60
Provider County Name
Boulder
Ownership Type
For profit - Limited Liability
Number of Certified Beds
165
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC BOULDER OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1985-10-01
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
1.67011
Reported LPN Staffing Hours per Resident per Day
0.88641
Reported RN Staffing Hours per Resident per Day
0.84620
Reported Licensed Staffing Hours per Resident per Day
1.73261
Reported Total Nurse Staffing Hours per Resident per Day
3.40272
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16685
Expected CNA Staffing Hours per Resident per Day
2.34296
Expected LPN Staffing Hours per Resident per Day
0.62858
Expected RN Staffing Hours per Resident per Day
1.01956
Expected Total Nurse Staffing Hours per Resident per Day
3.99110
Adjusted CNA Staffing Hours per Resident per Day
1.74905
Adjusted LPN Staffing Hours per Resident per Day
1.17045
Adjusted RN Staffing Hours per Resident per Day
0.62015
Adjusted Total Nurse Staffing Hours per Resident per Day
3.43666
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
17
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
156
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
78
Cycle 1 Total Health Score
234
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-07
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
17
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-02-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
145.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
Number of Fines
1
Total Amount of Fines in Dollars
1593
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
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BOULDER CO 80303 | 0.5 mile away
Mesa Vista Of Boulder
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BOULDER CO 80304 | 2.4 miles away
Manorcare Health Services - Boulder
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BOULDER CO 80301 | 3.1 miles away
Longmont United Hospital T C U
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LONGMONT CO 80501 | 13.8 miles away
Applewood Living Center
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LONGMONT CO 80501 | 14 miles away
Peaks Care Center The
1440 Coffman Street |
LONGMONT CO 80501 | 14.5 miles away
Life Care Center Of Longmont
2451 Pratt Street |
LONGMONT CO 80501 | 15.5 miles away
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