Cheyenne Manor
Cheyenne Manor Information
| Facility Name | Cheyenne Manor |
| Location | 561 W 1st St N, Cheyenne Wells, CO 80810 |
| County (SSA Code) | Cheyenne (80) |
| Phone Number | 719-767-5602 |
| Certification(s) | Medicaid |
| Number of Beds | 38 |
| Average Number of Residents | 22.8 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | Legal Business Name Not Available |
| Ownership Type | Government - County |
| Date First Approved | 1999-12-10 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.62446 |
| Reported LPN Staffing Hours per Resident per Day | 0.46109 |
| Reported RN Staffing - Hours per Resident per Day | 0.76855 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.22965 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.85411 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 1.83671 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.62537 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.26032 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 2.7224 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.51352 |
| Total Weighted Health Survey Score for three cycles | 0.667 |
| Rating cycle 1 Standard Survey Health Date | 2020-01-30 |
| Date of Rating cycle 2 Standard Health Survey Date | 2019-01-10 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-10-05 |
| Rating cycle 3 - Health Deficiency Score | 4 |
| Rating cycle 3 - Total Health Inspection Score | 4 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Substantiated Complaints | 0 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |