Mission San Miguel Nursing And Rehab Center - Commerce City Nursing Home
General Information
UPDATEFederal Provider Number
65318
Provider Name
MISSION SAN MIGUEL NURSING AND REHAB CENTER
Provider Address
7150 POPLAR STREET
COMMERCE CITY, CO 80022
COMMERCE CITY, CO 80022
Provider Phone Number
3032897110
Provider SSA County
0
Provider County Name
Adams
Ownership Type
For profit - Partnership
Number of Certified Beds
95
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINNACLE HEALTH FACILITIES XVI, L.P.
Date First Approved to Provide Medicare and Medicaid services
1994-02-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.22278
Reported LPN Staffing Hours per Resident per Day
0.70253
Reported RN Staffing Hours per Resident per Day
0.67595
Reported Licensed Staffing Hours per Resident per Day
1.37848
Reported Total Nurse Staffing Hours per Resident per Day
3.60126
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01646
Expected CNA Staffing Hours per Resident per Day
2.45944
Expected LPN Staffing Hours per Resident per Day
0.60206
Expected RN Staffing Hours per Resident per Day
0.91238
Expected Total Nurse Staffing Hours per Resident per Day
3.97387
Adjusted CNA Staffing Hours per Resident per Day
2.21759
Adjusted LPN Staffing Hours per Resident per Day
0.96851
Adjusted RN Staffing Hours per Resident per Day
0.55358
Adjusted Total Nurse Staffing Hours per Resident per Day
3.65294
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-03-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
21
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
252
Cycle 2 Standard Health Survey Date
2014-04-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-01-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
123.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
10
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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