Falcon Heights Rehabilitation and Nursing LLCCMS ratings, inspections and fines
- Address
- 1795 Monterey Rd, Colorado Springs, CO 80910
- CCN
- 065168
- Ownership type
- For-profit, corporation
- Certified beds
- 107
- Chain
- Chain name not shown
- Residents per day
- 89
- CMS flags
- CMS abuse icon
- Ownership changed in the last 12 months
The watch list stays in this browser. After each CMS update, it shows the values that changed at the homes on the list.
CMS gives Falcon Heights Rehabilitation and Nursing LLC an overall rating of 2 of 5 stars. The last standard survey was on 31 Jul 2024. The latest survey cycle has 17 health citations. The median for nursing homes in Colorado is 8. CMS lists 1 fine of $6,146 for this home in its penalties file.
Facilities may see a change in their overall rating for a number of reasons. Since the overall rating is based on three individual domains, a change in any one of the domains can affect the overall rating. Any new data for a nursing home could potentially change a star rating domain.
Centers for Medicare & Medicaid Services, Five-Star Quality Rating System: Technical Users' Guide, July 2026. CMS processed this record on .
Since the last CMS update
The site has no recorded change for this home. In each CMS update, the site compares the ratings, the penalties and the citations of each home.
Ratings
CMS gives each home 1 to 5 stars for health inspections, for staffing and for quality measures, and one overall rating.
| Rating (1 to 5 stars) | This home | El Paso County median | Colorado median | US average (CMS) |
|---|---|---|---|---|
| Overall rating | 2 | 3.0 | 3.0 | 3.0 |
| Health inspection rating | 2 | 2.0 | 2.0 | 2.8 |
| Staffing rating | 1 | 3.0 | 3.0 | 2.9 |
| Quality measure rating | 5 | 5.0 | 5.0 | 3.6 |
A median is the middle value of the homes in the group: 20 homes in the county, 210 homes in the state. What the CMS star ratings measure
Citations by survey cycle
CMS keeps the last three cycles, and cycle 1 is the latest. A cycle has one standard survey. Citations from complaint and infection control inspections go into cycles of 12 months.
| Survey cycle | Standard survey | Citations | Colorado median |
|---|---|---|---|
| Cycle 1 (latest) | 31 Jul 2024 | 17 | 8 |
| Cycle 2 | 22 Feb 2023 | 4 | 8 |
| Cycle 3 | No date | 15 | 6 |
Health citations
The record of one deficiency in an inspection. One inspection can give many citations.
Scope and severity. A letter from A to L on each citation. Scope is the number of residents that the deficiency affected. Severity is the level of harm.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | J0 | K0 | |
| Actual harm that is not immediate jeopardy | H0 | I0 | |
| No actual harm, potential for more than minimal harm | |||
| No actual harm, potential for minimal harm | A0 | B0 | C0 |
Survey cycle 1 (latest): 17 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 25 Feb 2026 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 20 Mar 2026 |
| 1 Dec 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 2 Dec 2025 |
| 31 Jul 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | G | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0555 | Honor the resident's right to choose his or her attending physician. | E | Complaint investigation | 28 Aug 2024 |
| 31 Jul 2024 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0679 | Provide activities to meet all resident's needs. | D | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint investigation | 28 Aug 2024 |
| 31 Jul 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0759 | Ensure medication error rates are not 5 percent or greater. | D | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | F | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 28 Aug 2024 |
| 31 Jul 2024 | F0923 | Have enough outside ventilation via a window or mechanical ventilation, or both. | E | Standard survey | 28 Aug 2024 |
Survey cycle 2: 4 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 3 Feb 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 28 Feb 2025 |
| 24 Sep 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 30 Oct 2024 |
| 24 Sep 2024 | F0626 | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | D | Complaint investigation | 8 Nov 2024 |
| 22 Feb 2023 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard survey | 18 Mar 2023 |
Survey cycle 3: 15 citations
The CMS provider file has no standard survey date for this cycle.
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 18 Nov 2021 | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | E | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0563 | Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. | F | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | F | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0692 | Provide enough food/fluids to maintain a resident's health. | D | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | F | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0880 | Provide and implement an infection prevention and control program. | F | Standard survey | 18 Dec 2021 |
| 18 Nov 2021 | F0886 | Perform COVID19 testing on residents and staff. | L | Standard survey | 18 Dec 2021 |
The requirement text is the CMS summary of the F-tag. It is not the report of the surveyor. How to read an inspection report
Penalties
A fine, or a payment denial: a period in which Medicare or Medicaid does not pay for new admissions. The CMS penalties file holds three years.
| Date | Type | Fine | Days without payment |
|---|---|---|---|
| 24 Sep 2024 | Fine | $6,146 |
Staffing
Hours per resident per day. The nurse hours for one resident on an average day. CMS calculates the figure from the hours that the home reports for a quarter.
| Staff | This home | Colorado median | Colorado average (CMS) |
|---|---|---|---|
| All nurse staff | 3.05 | 3.50 | 3.72 |
| Registered nurses (RN) | 0.52 | 0.70 | 0.82 |
| Licensed practical nurses (LPN) | 0.41 | 0.68 | |
| Nurse aides | 2.12 | 2.22 | |
| All nurse staff, weekends | 2.66 | 3.10 | 3.30 |
- Nurse staff turnover in a year
- 47.9%
- Nurse staff turnover, Colorado median
- 46.7%
- RN turnover in a year
- 58.8%
- Administrators who left in a year
- No data
Homes report the hours to CMS in the Payroll-Based Journal.
Quality measures
A figure that CMS calculates from the assessments of residents. One example is the percentage of long-stay residents with a fall and a major injury.
| Measure (CMS text) | Residents | This home | Colorado median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 8.7% | 11.1% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.0% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.9% | 0.9% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 1.2% | 3.0% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | 0.9% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 7.8% | 11.9% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 0.4% | 3.0% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 27.6% | 18.8% | 13.4% |
For each measure in this table, CMS gives more points in the quality measure rating for a lower percentage. The site calculates the medians from the CMS file. What the CMS star ratings measure
Ownership
An organisation in the CMS ownership file. CMS records its role, for example an ownership interest, operational or managerial control, or a mortgage interest.
- Ownership type
- For-profit, corporation
- Chain
- Chain name not shown
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Cottonwood Healthcare LLC | Operational/managerial control | 1 Sep 2024 |
The site shows organisations only. It does not show the names of persons. CMS lists this home in a chain that has the name of a person, so the site shows no chain name and no chain page.
Other homes in El Paso County
| Nursing home | City | Overall rating | Citations, latest cycle | Fines | Last standard survey | |
|---|---|---|---|---|---|---|
| Fountain View Rehabilitation and Nursing LLC | Colorado Springs | 3 of 5 | 10 | $0 | 19 Sep 2024 | |
| Life Care Center of Colorado Springs | Colorado Springs | 5 of 5 | 5 | $32,260 | 26 Feb 2026 | |
| Advanced Health Care of Colorado Springs | Colorado Springs | 5 of 5 | 0 | $0 | 25 Jun 2026 | |
| Mountain View Post Acute | Colorado Springs | 2 of 5 | 12 | $29,224 | 11 Dec 2025 | |
| Medallion Post Acute Rehabilitation | Colorado Springs | 1 of 5 | 16 | $86,723 | 15 Aug 2024 | |
| Sunny Vista Living Center | Colorado Springs | 3 of 5 | 6 | $0 | 24 Jul 2025 | |
| Kiowa Hills Rehabilitation and Nursing, LLC | Colorado Springs | 1 of 5 | 21 | $0 | 16 Jan 2025 | |
| Pikes Peak Post Acute | Colorado Springs | 1 of 5 | 12 | $89,318 | 30 Jan 2025 | |
| Colonial Rehabilitation and Nursing, LLC | Colorado Springs | 1 of 5 | 16 | $24,453 | 24 Jul 2025 | |
| Bear Creek Senior Living | Colorado Springs | 4 of 5 | 1 | $6,614 | 11 Feb 2026 | |
| Springs Village Care Center | Colorado Springs | 2 of 5 | 10 | $26,845 | 15 May 2025 | |
| Brookdale Skyline | Colorado Springs | 5 of 5 | 6 | $9,110 | 17 Apr 2025 |
Official channels
- Care Compare record of this nursing homeMedicare.gov. The official CMS record of this home.
- Contact information for State Survey AgenciesCMS. The web address and the telephone number of the State Survey Agency of each state. These agencies investigate complaints about nursing homes.
- Filing a complaintMedicare.gov. The page names the State Survey Agency as the place for a complaint about nursing home care or facility conditions.
- Eldercare LocatorAdministration for Community Living. A public service that connects older adults and their families to local services. Telephone: 1-800-677-1116.
Cite this page
Centers for Medicare & Medicaid Services, Care Compare. Record of Falcon Heights Rehabilitation and Nursing LLC (CCN 065168). Data processed 1 Aug 2026. Elder Care Record, https://eldercarerecord.com/facility/falcon-heights-rehabilitation-and-nursing-llc-colorado-springs-co-065168/
Provenance
- Licence
- US government work, public domain
- CMS processed the data on
A program makes this page from the CMS files, and the same files always give the same text. How the site makes the figures. Report an error.
Questions
- When was Falcon Heights Rehabilitation and Nursing LLC last inspected?
- The latest inspection with a citation in the CMS record was on 25 Feb 2026. It was a complaint investigation. It gave 1 citation. The standard survey before the last one was on 22 Feb 2023.
- Who operates Falcon Heights Rehabilitation and Nursing LLC?
- The CMS record gives the ownership type as for-profit, corporation. CMS lists the home in a chain that has the name of a person. This site does not show that name. The CMS ownership file names Cottonwood Healthcare LLC for operational or managerial control. This site does not show the names of persons.
- Is Falcon Heights Rehabilitation and Nursing LLC a Special Focus Facility?
- No. The CMS provider file lists no Special Focus status for this home. CMS lists no home in Colorado as a Special Focus Facility and 5 as candidates.
- Where does the data on this page come from?
- The data comes from the CMS Care Compare files for nursing homes. CMS processed the files on 1 Aug 2026. The Care Compare record on Medicare.gov is the official record of the home.