Brookdale Green Mountain - Lakewood Nursing Home
General Information
UPDATEFederal Provider Number
65374
Provider Name
BROOKDALE GREEN MOUNTAIN
Provider Address
12791 W ALAMEDA PARKWAY
LAKEWOOD, CO 80228
LAKEWOOD, CO 80228
Provider Phone Number
3032375700
Provider SSA County
290
Provider County Name
Jefferson
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
36
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
EMERICARE INC
Date First Approved to Provide Medicare and Medicaid services
1999-12-30
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.32083
Reported LPN Staffing Hours per Resident per Day
0.33889
Reported RN Staffing Hours per Resident per Day
1.67500
Reported Licensed Staffing Hours per Resident per Day
2.01389
Reported Total Nurse Staffing Hours per Resident per Day
4.33472
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03750
Expected CNA Staffing Hours per Resident per Day
2.44386
Expected LPN Staffing Hours per Resident per Day
0.64657
Expected RN Staffing Hours per Resident per Day
1.15550
Expected Total Nurse Staffing Hours per Resident per Day
4.24592
Adjusted CNA Staffing Hours per Resident per Day
2.33018
Adjusted LPN Staffing Hours per Resident per Day
0.43503
Adjusted RN Staffing Hours per Resident per Day
1.08313
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11520
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-07-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-07-31
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
18
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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