Cheyenne Mountain Center - Colorado Springs Nursing Home
General Information
UPDATEFederal Provider Number
65147
Provider Name
CHEYENNE MOUNTAIN CENTER
Provider Address
835 TENDERFOOT HILL ROAD
COLORADO SPRINGS, CO 80906
COLORADO SPRINGS, CO 80906
Provider Phone Number
(719) 576-8380
Provider SSA County
200
Provider County Name
El Paso
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
159
Number of Residents in Certified Beds
143
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PEAK MEDICAL COLORADO NO. 2, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-12-01
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
Partial
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
2.10140
Reported LPN Staffing Hours per Resident per Day
0.64266
Reported RN Staffing Hours per Resident per Day
1.05280
Reported Licensed Staffing Hours per Resident per Day
1.69545
Reported Total Nurse Staffing Hours per Resident per Day
3.79686
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06608
Expected CNA Staffing Hours per Resident per Day
2.35653
Expected LPN Staffing Hours per Resident per Day
0.70488
Expected RN Staffing Hours per Resident per Day
1.22918
Expected Total Nurse Staffing Hours per Resident per Day
4.29059
Adjusted CNA Staffing Hours per Resident per Day
2.18805
Adjusted LPN Staffing Hours per Resident per Day
0.75673
Adjusted RN Staffing Hours per Resident per Day
0.63998
Adjusted Total Nurse Staffing Hours per Resident per Day
3.56705
Cycle 1 Total Number of Health Deficiencies
32
Cycle 1 Number of Standard Health Deficiencies
28
Cycle 1 Number of Complaint Health Deficiencies
27
Cycle 1 Health Deficiency Score
297
Cycle 1 Standard Survey Health Date
2014-03-06
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
149
Cycle 1 Total Health Score
446
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-04-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
124
Cycle 3 Standard Health Survey Date
2012-03-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
124
Total Weighted Health Survey Score
271.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
16
Number of Fines
2
Total Amount of Fines in Dollars
8743
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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