Mesa Vista Of Boulder - Boulder Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
65052
Provider Name
MESA VISTA OF BOULDER
Provider Address
2121 MESA DRIVE
BOULDER, CO 80304
BOULDER, CO 80304
Provider Phone Number
(303) 442-4037
Provider SSA County
60
Provider County Name
Boulder
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
162
Number of Residents in Certified Beds
145
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WAVERLEY - COLORADO, INC.
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
1.96034
Reported LPN Staffing Hours per Resident per Day
0.33241
Reported RN Staffing Hours per Resident per Day
0.87931
Reported Licensed Staffing Hours per Resident per Day
1.21172
Reported Total Nurse Staffing Hours per Resident per Day
3.17206
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00552
Expected CNA Staffing Hours per Resident per Day
2.00665
Expected LPN Staffing Hours per Resident per Day
0.55494
Expected RN Staffing Hours per Resident per Day
0.74709
Expected Total Nurse Staffing Hours per Resident per Day
3.30867
Adjusted CNA Staffing Hours per Resident per Day
2.39707
Adjusted LPN Staffing Hours per Resident per Day
0.49718
Adjusted RN Staffing Hours per Resident per Day
0.87944
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86447
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2013-08-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
100
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2012-06-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
68.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
3050
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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