Brookdale Skyline - Colorado Springs Nursing Home
General Information
UPDATEFederal Provider Number
65382
Provider Name
BROOKDALE SKYLINE
Provider Address
2365 PATRIOT HEIGHTS
COLORADO SPRINGS, CO 80904
COLORADO SPRINGS, CO 80904
Provider Phone Number
(719) 667-5360
Provider SSA County
200
Provider County Name
El Paso
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
51
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
BLC-VILLAGE AT SKYLINE LLC
Date First Approved to Provide Medicare and Medicaid services
2003-11-26
Continuing Care Retirement Community
Y
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
4
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
1.97549
Reported LPN Staffing Hours per Resident per Day
1.39510
Reported RN Staffing Hours per Resident per Day
1.39706
Reported Licensed Staffing Hours per Resident per Day
2.79216
Reported Total Nurse Staffing Hours per Resident per Day
4.76765
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11176
Expected CNA Staffing Hours per Resident per Day
2.62597
Expected LPN Staffing Hours per Resident per Day
0.65554
Expected RN Staffing Hours per Resident per Day
1.05972
Expected Total Nurse Staffing Hours per Resident per Day
4.34123
Adjusted CNA Staffing Hours per Resident per Day
1.84589
Adjusted LPN Staffing Hours per Resident per Day
1.76639
Adjusted RN Staffing Hours per Resident per Day
0.98506
Adjusted Total Nurse Staffing Hours per Resident per Day
4.42684
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-10-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
33.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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