| General |
| City |
| Englewood |
Denver |
| State attribute explanation |
| Co |
Co |
| Street |
| 3636 South Pearl Street |
735 South Locust Street |
| Zip Code |
| 80,110 |
80,224 |
| Phone |
| 3,037,611,640 |
3,033,204,377 |
|
Overall Star Rating |
| 2 |
4 |
|
Health Inspections Star Rating |
| 2 |
4 |
|
Nurse Staffing Star Rating |
| 3 |
3 |
|
Quality Measures Star Rating |
| 3 |
3 |
|
RN Only Star Rating |
| 4 |
4 |
|
Number of Certified Beds |
| 81 |
118 |
|
Total Number of Residents |
| 56 |
79 |
|
Percent of Occupied Beds |
| 69 % |
67 % |
| Health Survey Date |
| 2/14/2012 |
11/16/2011 |
| Fire Survey Date |
| 3/9/2012 |
12/15/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
Yes |
| Resident and Family Councils |
| Both |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| Yes |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
75.2 |
| Total Enforcement Actions Count |
| 75.2 |
75.2 |
| # of deficiencies |
| 23 |
2 |
|
| Staff Information |
| Number of Residents |
| 56 |
79 |
| Number of RN Hours Per Resident Per Day |
| 0.82 |
0.87 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.74 |
0.74 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.56 |
1.61 |
| Number of CNA Hours Per Resident Per Day |
| 0.1 |
0.18 |
| Number Therapy Hours Per Resident Per Day |
| 0.1 |
0.18 |
| Environmental Deficiencies |
| Deficiency #1 |
| Scope: Manylevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #3 |
| Scope: Somelevel Of Harm: 2deficiency: Maintain Comfortable And Safe Temperature Levels.survey Date: 02/14/2012date Of Correction: 03/20/2012 |
|
| Deficiency #4 |
| Scope: Somelevel Of Harm: 2deficiency: Provide A Safe, Clean, Comfortable And Homelike Environment.survey Date: 02/14/2012date Of Correction: 03/20/2012 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 08/30/2011date Of Correction: Not Available |
|
| Mistreatment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Keep Each Resident Free From Physical Restraints, Unless Needed For Medical Treatment.survey Date: 02/14/2012date Of Correction: 03/20/2012 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
| Scope: Somelevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
Scope: Somelevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 06/03/2010date Of Correction: 07/02/2010 |
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 3deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 06/06/2012date Of Correction: 07/13/2012 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure Services Provided By The Nursing Facility Meet Professional Standards Of Quality.survey Date: 06/06/2012date Of Correction: 07/13/2012 |
|
| Deficiency #3 |
| Scope: Somelevel Of Harm: 2deficiency: Have Enough Nurses To Care For Every Resident In A Way That Maximizes The Resident's Well Being.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #4 |
| Scope: Fewlevel Of Harm: 2deficiency: Assist Those Residents Who Need Total Help With Eating/drinking, Grooming And Personal And Oral Hygiene.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Residents Receive Treatment/services To Not Only Continue, But Improve The Ability To Care For Themselves.survey Date: 02/14/2012date Of Correction: 03/20/2012 |
|
| Deficiency #6 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #7 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 08/30/2011date Of Correction: Not Available |
|
| Deficiency #8 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Medically-related Social Services To Help Each Resident Achieve The Highest Possible Quality Of Life.survey Date: 08/30/2011date Of Correction: Not Available |
|
| Resident Assessment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Allow The Resident The Right To Participate In The Planning Or Revision Of The Resident's Care Plan.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
Scope: Fewlevel Of Harm: 2deficiency: Make Sure Each Resident Receives An Accurate Assessment By A Qualified Health Professional.survey Date: 05/30/2012date Of Correction: 06/29/2012 |
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Pharmacy Service Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Make Sure That Residents Are Safe From Serious Medication Errors.survey Date: 06/06/2012date Of Correction: 07/13/2012 |
|
| Deficiency #2 |
| Scope: Somelevel Of Harm: 2deficiency: Maintain Drug Records And Properly Mark/label Drugs And Other Similar Products According To Accepted Professional Standards.survey Date: 02/14/2012date Of Correction: 03/20/2012 |
|
| Deficiency #3 |
| Scope: Somelevel Of Harm: 2deficiency: Keep The Rate Of Medication Errors (wrong Drug, Wrong Dose, Wrong Time) To Less Than 5%.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #4 |
| Scope: Somelevel Of Harm: 2deficiency: 1) Make Sure That Each Resident's Drug Regimen Is Free From Unnecessary Drugs; 2) Each Resident's Entire Drug/medication Is Managed And Monitored To Achieve Highest Well Being.survey Date: 02/14/2012date Of Correction: 03/26/2012 |
|
| Deficiency #5 |
| Scope: Fewlevel Of Harm: 2deficiency: Safely Provide Drugs And Other Similar Products Available, Which Are Needed Every Day And In Emergencies, By A Licensed Pharmacist.survey Date: 08/30/2011date Of Correction: Not Available |
|
| Nutrition and Dietary Deficiencies |
| Deficiency #1 |
| Scope: Somelevel Of Harm: 2deficiency: Prepare Food That Is Nutritional, Appetizing, Tasty, Attractive, Well-cooked, And At The Right Temperature.survey Date: 02/14/2012date Of Correction: 03/20/2012 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 10.9 % |
8.6:1 |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 1.3 % |
1.4 % |
| Percent of long-stay residents who self-report moderate to severe pain |
|
7.8 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 75.2 % |
5.1 % |
| Percent of long-stay residents who lose too much weight |
| 8.7 % |
4.3 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 64.5 % |
|
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 7.3 % |
6.6 % |
| Percent of long-stay residents with a urinary tract infection |
| 4.3 % |
14.7:1 |
| Percent of long-stay residents who have depressive symptoms |
| 6.4 % |
2.8 % |
| Percent of long-stay residents who were physically restrained |
| 2.1 % |
1.4 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 25 % |
50 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 81 % |
82.4 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 79.3 % |
100 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
12.8:1 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 2.1 % |
1.4 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 9.4 / 10.4 |
10.9 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 4.6 % |
1.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 24.4 % |
7.9:1 |
| Percent of long-stay high-risk residents with pressure ulcers |
| 75.2 % |
5.1 % |
| Percent of long-stay residents who lose too much weight |
| 7 % |
6.1 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 66.7 % |
46.6 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3.9 % |
4.3 % |
| Percent of long-stay residents with a urinary tract infection |
| 4.9 % |
13.2 % |
| Percent of long-stay residents who have depressive symptoms |
| 3.5 % |
4 % |
| Percent of long-stay residents who were physically restrained |
| 0.7 % |
2.5 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 4.2 % |
2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 28.6 % |
32.7 (90.9) |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 83.5 % |
86.6 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 77.3 % |
100 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 13 % |
7.9:1 |