Map showing the location of WESTWOOD POST ACUTE in DENVER, Colorado
3185 W ARKANSAS AVE, DENVER, CO, 80219

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • ColoradoAbove only 14% of peers208 rated homes · average 3.1★
  • Denver CountyAbove only 5% of peers22 rated homes · average 3.1★
  • United StatesAbove only 20% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.7 vs CO avg
  • StaffingCan add or remove a star4★+0.9 vs CO avg
  • Quality measuresCan add or remove a star5★+0.8 vs CO avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

  • Special Focus Facility candidateThis facility is on the CMS candidate list for the Special Focus Facility program, meaning it is among the poorest-performing facilities in its state on recent inspections.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersCO avg2.7★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover4★Above 57% of peersCO avg3.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above 50% of peersCO avg4.2★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.44hrsAbove only 49% of peersCO avg3.73Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.61hrsAbove only 30% of peersCO avg0.83Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better36%Above 81% of peersCO avg49%RN turnover55%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$78,371Above only 10% of peersCO avg$25,587Fines · denials3 · 2
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
50citations
4inspection dates
4actual harm (G–I)
2immediate jeopardy (J–L)
Apr 25, 2025most recent

Citations by monthFeb 2020 – Apr 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Apr 25, 202521 citationsCycle 1worst J · immediate jeopardy$36,860, payment denial
  1. F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.EnvironmentalD · isolatedCorrected May 15, 2025
  2. F626Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy.Resident RightsD · isolatedCorrected May 15, 2025
  3. Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.Resident RightsD · isolatedCorrected May 1, 2025
  4. Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.Nutrition and DietaryE · patternCorrected May 15, 2025
  5. F699Provide care or services that was trauma informed and/or culturally competent.Quality of Life and CareD · isolatedCorrected May 15, 2025
  6. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected May 15, 2025
  7. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected May 15, 2025
  8. F567Honor the resident's right to manage his or her financial affairs.Resident RightsE · patternCorrected May 9, 2025
  9. F577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.Resident RightsC · widespreadCorrected May 1, 2025
  10. F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.Resident Assessment and Care PlanningD · isolatedCorrected May 15, 2025
  11. F282Provide care by qualified persons according to each resident's written plan of care.Resident Assessment and Care PlanningD · isolatedCorrected May 15, 2025
  12. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected May 16, 2025
  13. F679Provide activities to meet all resident's needs.Quality of Life and CareD · isolatedCorrected May 15, 2025
  14. F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareD · isolatedCorrected May 15, 2025
  15. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Apr 30, 2025
  16. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceE · patternCorrected May 15, 2025
  17. F791Provide or obtain dental services for each resident.Quality of Life and CareD · isolatedCorrected May 15, 2025
  18. F807Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.Nutrition and DietaryE · patternCorrected May 1, 2025
  19. F848Provide a neutral and fair arbitration process and agree to arbitrator and venue.AdministrationF · widespreadCorrected May 12, 2025
  20. F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationF · widespreadCorrected May 15, 2025
  21. F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlD · isolatedCorrected May 15, 2025
Mar 7, 202417 citationsCycle 2worst J · immediate jeopardy$29,177, payment denial
  1. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareG · isolatedCorrected Apr 5, 2024
  2. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Apr 30, 2024
  3. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Apr 30, 2024
  4. F565Honor the resident's right to organize and participate in resident/family groups in the facility.Resident RightsE · patternCorrected Apr 30, 2024
  5. F584Honor 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.Resident RightsD · isolatedCorrected Apr 30, 2024
  6. F585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.Resident RightsD · isolatedCorrected Apr 30, 2024
  7. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareG · isolatedCorrected Apr 30, 2024
  8. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareE · patternCorrected Apr 30, 2024
  9. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareG · isolatedCorrected Apr 30, 2024
  10. F691Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Apr 30, 2024
  11. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesE · patternCorrected Apr 30, 2024
  12. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceJ · isolatedCorrected Apr 30, 2024
  13. F803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.Nutrition and DietaryD · isolatedCorrected Apr 30, 2024
  14. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryE · patternCorrected Apr 30, 2024
  15. F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Nutrition and DietaryD · isolatedCorrected Apr 30, 2024
  16. F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationF · widespreadCorrected Apr 5, 2024
  17. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Apr 30, 2024
Sep 28, 20235 citationsCycle 2worst G · actual harm$12,334
  1. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceG · isolatedCorrected Oct 21, 2023
  2. F761Ensure 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.Pharmacy ServiceE · patternCorrected Oct 21, 2023
  3. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Oct 21, 2023
  4. F552Ensure that residents are fully informed and understand their health status, care and treatments.Resident RightsE · patternCorrected Oct 21, 2023
  5. F584Honor 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.Resident RightsE · patternCorrected Oct 21, 2023
Feb 27, 20207 citationsCycle 3worst F · no actual harm
  1. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Mar 27, 2020
  2. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Apr 2, 2020
  3. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Apr 11, 2020
  4. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Mar 27, 2020
  5. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Apr 10, 2020
  6. F679Provide activities to meet all resident's needs.Quality of Life and CareD · isolatedCorrected Mar 18, 2020
  7. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareD · isolatedCorrected Mar 27, 2020

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.44hrsAbove only 49% of peers−0.29 vs CO avg
  • Registered nursesRN hours only0.61hrsAbove only 30% of peers−0.22 vs CO avg
  • Licensed practical nursesLPN hours0.65hrs
  • Nurse aidesCNA hours2.18hrs
  • Weekend nursingAll staff on Saturdays and Sundays2.85hrs
  • Colorado average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better36%Above 81% of peersCO avg 49%
  • RN turnoverRegistered nurses only55%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy85 certified beds · ~68 residents a day80%Above only 42% of peersCO avg 79%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $78,371In fines
  • 3Fines
  • 2Payment denials
  • $25,587CO avg in fines
Above only 10% of peersFewer fines than 10% of rated homes in Colorado

Actions on record

  1. Apr 25, 2025Civil money penalty$36,860
  2. Apr 25, 2025Denial of payment for new admissionsfrom May 21, 2025
  3. Mar 7, 2024Civil money penalty$29,177
  4. Mar 7, 2024Denial of payment for new admissionsfrom Apr 5, 2024
  5. Sep 28, 2023Civil money penalty$12,334

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
Pacs Group254 facilities in the chain2.9★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Centennial Master Tenant, LLC
Indirect owners (5%+)
  • Pacs Group, INC.
  • Pacs Holdings, LLC
  • Providence Group Nh, LLC
  • Mark Hancock
  • Jason Murray
Corporate officers
  • Frederick Apt
  • Mark Hancock
  • Joshua Jergensen
  • John Mitchell
Contracted managers
  • Christopher Horton
Managing employees
  • Angela Connor

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 065274 · 3185 W ARKANSAS AVE, DENVER, CO, 80219.
  • Percentiles compare this facility with every rated nursing home in Colorado and Denver County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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