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Grace Manor Care Center - Burlington Nursing Home

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Federal Provider Number
65284
Provider Name
GRACE MANOR CARE CENTER
Provider Address
465 FIFTH STREET
BURLINGTON, CO 80807
Provider Phone Number
(719) 346-7512
Provider SSA County
310
Provider County Name
Kit Carson
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
37
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BURLINGTON NURSING HOME LLC
Date First Approved to Provide Medicare and Medicaid services
1990-12-01
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
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.30441
Reported LPN Staffing Hours per Resident per Day
0.38676
Reported RN Staffing Hours per Resident per Day
0.70294
Reported Licensed Staffing Hours per Resident per Day
1.08971
Reported Total Nurse Staffing Hours per Resident per Day
3.39411
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00882
Expected CNA Staffing Hours per Resident per Day
2.36826
Expected LPN Staffing Hours per Resident per Day
0.56985
Expected RN Staffing Hours per Resident per Day
0.90827
Expected Total Nurse Staffing Hours per Resident per Day
3.84638
Adjusted CNA Staffing Hours per Resident per Day
2.38755
Adjusted LPN Staffing Hours per Resident per Day
0.56333
Adjusted RN Staffing Hours per Resident per Day
0.57828
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55693
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-11-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
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
84
Cycle 2 Standard Health Survey Date
2013-11-07
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
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
63.33300
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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