Trinidad Inn Nursing Home - Trinidad Nursing Home
General Information
UPDATEFederal Provider Number
65396
Provider Name
TRINIDAD INN NURSING HOME
Provider Address
409 BENEDICTA AVENUE
TRINIDAD, CO 81082
TRINIDAD, CO 81082
Provider Phone Number
7198469291
Provider SSA County
350
Provider County Name
Las Animas
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRINIDAD INN, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-10-26
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.63608
Reported LPN Staffing Hours per Resident per Day
0.74227
Reported RN Staffing Hours per Resident per Day
0.25773
Reported Licensed Staffing Hours per Resident per Day
1.00000
Reported Total Nurse Staffing Hours per Resident per Day
3.63608
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01082
Expected CNA Staffing Hours per Resident per Day
2.24177
Expected LPN Staffing Hours per Resident per Day
0.65428
Expected RN Staffing Hours per Resident per Day
0.97178
Expected Total Nurse Staffing Hours per Resident per Day
3.86783
Adjusted CNA Staffing Hours per Resident per Day
2.88528
Adjusted LPN Staffing Hours per Resident per Day
0.94162
Adjusted RN Staffing Hours per Resident per Day
0.19817
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78938
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-03-17
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
171
Cycle 2 Standard Health Survey Date
2014-02-20
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-03-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
106.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
5395
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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