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Lakewood Villa - Lakewood Nursing Home

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Federal Provider Number
65408
Provider Name
LAKEWOOD VILLA
Provider Address
1625 SIMMS STREET
LAKEWOOD, CO 80215
Provider Phone Number
(303) 238-8161
Provider SSA County
290
Provider County Name
Jefferson
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
LAKEWOOD VILLA OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
2013-06-01
Continuing Care Retirement Community
N
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.14216
Reported LPN Staffing Hours per Resident per Day
0.53922
Reported RN Staffing Hours per Resident per Day
1.02255
Reported Licensed Staffing Hours per Resident per Day
1.56176
Reported Total Nurse Staffing Hours per Resident per Day
3.70393
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05588
Expected CNA Staffing Hours per Resident per Day
2.26147
Expected LPN Staffing Hours per Resident per Day
0.54882
Expected RN Staffing Hours per Resident per Day
0.78835
Expected Total Nurse Staffing Hours per Resident per Day
3.59864
Adjusted CNA Staffing Hours per Resident per Day
2.32425
Adjusted LPN Staffing Hours per Resident per Day
0.81548
Adjusted RN Staffing Hours per Resident per Day
0.96917
Adjusted Total Nurse Staffing Hours per Resident per Day
4.14884
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-01-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
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
48
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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