Broomfield Skilled Nursing And Rehabilitation Ctr - Broomfield Nursing Home
General Information
UPDATEFederal Provider Number
65379
Provider Name
BROOMFIELD SKILLED NURSING AND REHABILITATION CTR
Provider Address
12975 SHERIDAN BOULEVARD
BROOMFIELD, CO 80020
BROOMFIELD, CO 80020
Provider Phone Number
3037855800
Provider SSA County
630
Provider County Name
Broomfield
Ownership Type
For profit - Corporation
Number of Certified Beds
210
Number of Residents in Certified Beds
162
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2002-03-06
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.32500
Reported LPN Staffing Hours per Resident per Day
0.72253
Reported RN Staffing Hours per Resident per Day
0.85710
Reported Licensed Staffing Hours per Resident per Day
1.57963
Reported Total Nurse Staffing Hours per Resident per Day
3.90463
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08395
Expected CNA Staffing Hours per Resident per Day
2.32167
Expected LPN Staffing Hours per Resident per Day
0.61689
Expected RN Staffing Hours per Resident per Day
1.00987
Expected Total Nurse Staffing Hours per Resident per Day
3.94844
Adjusted CNA Staffing Hours per Resident per Day
2.45722
Adjusted LPN Staffing Hours per Resident per Day
0.97213
Adjusted RN Staffing Hours per Resident per Day
0.63417
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98618
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-05-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
25
Cycle 2 Number of Standard Health Deficiencies
25
Cycle 2 Number of Complaint Health Deficiencies
15
Cycle 2 Health Deficiency Score
349
Cycle 2 Standard Health Survey Date
2013-06-24
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
175
Cycle 2 Total Health Score
175
Cycle 3 Total Number of Health Deficiencies
24
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
152
Cycle 3 Standard Health Survey Date
2012-05-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
152
Total Weighted Health Survey Score
248.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
18
Number of Fines
2
Total Amount of Fines in Dollars
63028
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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