Colorado Active and Potential NATCEP Loss Report August 2017 Extracted from the 07/24/2017 NATCEP Loss Report

Provider Name City, State, Zip AIM Home Health LLC Pueblo, CO 81008 Alpine Living Center Thornton, CO 80229 Applewood Living Longmont, CO 80501 Applewood Living Longmont, CO 80501 Applewood Living Longmont, CO 80501 Angels Care Home Aurora, CO 80014 Aspen Living Center Colorado Springs Avamere Brighton, CO 80601 Avantara Crown Parker, CO 80138 Belmont Lodge Pueblo, CO 81001 Belmont Lodge Pueblo, CO 81001 Bethany Nursing & Lakewood, CO 80226 Beth Israel At Aurora, CO 80015 Brookdale Mountain Denver, CO 80247 Castle Rock Care Castle Rock, CO 80108 Castle Rock Care Castle Rock 80108 Cedarwood Health Colorado Springs Cherry Creek Aurora, CO 80014 Colonial Columns Colorado Springs Colorado State Rifle, CO 81650 Complete Home Broomfield, CO 80020 Elms Haven Center Thornton, CO 80241 Family Home Health Boulder, CO 80301 Garden Terrace Aurora, CO 80012

Case ID

NATCEP Loss Eff. Date

Loss Last Day

CO6YGD

5/2/2017

5/1/2019

COZ2YW

3/8/2017

3/7/2019

COW0LN

10/2/2015

10/1/2017

COK0IY

11/22/2016

11/21/2018

COSRYC

2/8/2017

2/7/2019

CO9X2Q

9/1/2016

8/31/2018

CO8XU2

10/23/2015

10/22/2017

COC177

11/17/2015

11/16/2017

COI6M7

5/21/2017

5/20/2019

CO5Y78

12/8/2015

12/7/2017

COCSRT

11/24/2016

11/23/2018

CO3U6M

8/15/2016

8/14/2018

COOSKK

9/30/2015

9/29/2017

COTX3F

1/14/2016

1/13/2018

CON4EF

2/24/2016

2/23/2018

COIHPR

12/12/2016

12/11/2018

COWTG1

9/15/2015

9/14/2017

COUGH9

1/4/2016

1/3/2018

COIFCZ

1/14/2016

1/13/2018

COGG31

12/10/2016

12/9/2018

COCD9D

10/13/2016

10/12/2018

CO1LUR

10/21/2015

10/20/2017

COOFIV

7/23/2015

7/22/2017

COHDZN

7/21/2015

7/20/2017

1 7/25/2017rb

Colorado Active and Potential NATCEP Loss Report August 2017 Extracted from the 07/24/2017 NATCEP Loss Report

Provider Name City, State, Zip Glenwood Springs Glenwood Springs Golden Harmony Aurora, CO 80011 Hallmark Nursing Denver, CO 80236 Harmony Pointe Lakewood, CO 80214 Heritage Park Care Carbondale, CO 81623 Homecare of the Glenwood Springs Human Touch Home Thornton, CO 80260 Juniper Village, The Denver, CO 80211 La Villa Grande Care Grand Junction, CO LeMay Avenue Health Ft. Collins, CO Maxim Healthcare Denver, CO 80211 Maxim Healthcare Colorado Springs Minnequa Medicenter Pueblo, CO 81004 Monaco Parkway Denver, CO 80224 Monaco Parkway Denver, CO 80224 Mount St Francis Colorado Springs Mountain Vista Wehat Ridge, CO 80033 Nursecore of Denver, CO 80222 Palisades Living Palisade, CO 81526 Palisade Living Palisade, CO 81526 Palisade Living Palisade, CO 81526 Pearl Street Health Englewood, CO 80110 Powerback Lakewood, CO 80227 Regent Park Nursing Holyoke, CO 80734

Case ID

NATCEP Loss Eff. Date

Loss Last Day

COD2H9

1/11/2017

1/10/2019

COGIQ3

12/17/2015

12/16/2017

COYRLE

10/31/2016

10/30/2018

COY7ZN

5/24/2016

5/23/2018

COSL3I

6/23/2017

6/22/2019

COJU9B

3/18/2016

3/17/2018

COE768

2/23/2016

2/22/2018

COK3TD

12/15/2016

12/14/2018

COTU19

11/11/2015

11/10/2017

COBWBL

2/13/2017

2/12/2019

COX6EB

1/6/2016

1/5/2018

COIJ5E

3/2/2017

3/1/2019

COJDQW

8/21/2015

8/20/2017

COXD71

3/2/2017

3/1/2019

COGKVL

7/15/2016

7/14/2018

CO9943

3/21/2017

3/20/2019

CO1S8W

4/6/2016

4/5/2018

COWGTS

12/8/2015

12/7/2017

COL6ZP

10/12/2016

10/11/2018

COS6VR

9/17/2015

9/16/2017

COR5DR

2/21/2017

2/20/2019

CON4MU

3/23/2017

3/22/2019

CO67CO

8/2/2016

8/1/2018

COV9LN

10/17/2015

10/16/2017

2 7/25/2017rb

Colorado Active and Potential NATCEP Loss Report August 2017 Extracted from the 07/24/2017 NATCEP Loss Report

Provider Name City, State, Zip Rehabilitation and Ft. Collins, CO Reliable Home Wheat Ridge, CO 80033 San Juan Living Montrose, CO 81401 San Juan Living Montrose, CO 81401 Sierra Vista Health Loveland, CO 80537 St Andrews Aurora, CO 80014 Sterling Living Sterling, CO 80751 Sterling Living Sterling, CO 80751 Suites at Clermont Denver, CO 80222 Terrace Gardens Colorado Springs Tru Community Care Lafayette, CO 80026 Union Printers Colorado Springs, CO University Park Care Pueblo, CO 81001 Uptown Health Care Denver, CO 80203 Villas at Sunny Thornton, CO 80233 Yuma Life Care Yuma, CO 80759 Yuma Life Care Yuma, CO 80759 Yuma Life Care Yuma, CO 80759

Case ID

NATCEP Loss Eff. Date

Loss Last Day

CO4V17

2/18/2016

2/17/2018

COV1YO

2/2/2017

2/1/2019

COR4OV

6/17/2016

6/16/2018

COTOMR

3/21/2017

3/20/2019

CO4FG6

2/14/2017

2/13/2019

CONXBJ

5/12/2017

5/11/2019

COW89D

5/13/2016

5/12/2018

CO6MH7

5/19/2017

5/18/2019

COSSVQ

4/27/2017

4/26/2019

CODGMP

1/11/2017

1/10/2019

COXLEX

12/23/2016

12/22/2018

COS7B3

5/25/2016

5/24/2018

COKSBD

12/20/2016

12/19/2018

CONPBY

11/21/2016

11/20/2018

COJQTS

3/23/2017

3/22/2019

COGIPE

10/2/2015

10/1/2017

COGQU9

1/26/2016

1/25/2018

COGX0R

11/1/2016

10/31/2018

3 7/25/2017rb

Colorado Active and Potential NATCEP Loss Report August 2017 Extracted from the 07/24/2017 NATCEP Loss Report

Potential NATCEP Loss Provider Name City, State, Zip Advanced Health Colorado Springs Avamere Brighton, CO 80601 Belmont Lodge Pueblo, CO 81001 Bethany Nursing & Lakewood, CO 80226 Boulder Manor Boulder, CO 80303 Broomfield Skilled Broomfield, CO 80020 Casey’s Pond Senior Steamboat Springs Castle Rock Care Castle Rock, CO 80108 Cedars Healthcare Lakewood, CO 80214 Cedars Healthcare Lakewood, CO 80214 Center at Lincoln Parker, CO 80134 Center at Lincoln Parker, CO 80134 Cherrelyn Littleton, CO 80120 Christopher House Wheat Ridge, CO 80033 Colonial Columns Colorado Springs Colorado State Aurora, CO 80045 Colorado Veterans Monte Vista, CO 81144 Colorow Care Olathe, CO 81425 Devonshire Acres Sterling, CO 80751 Eben Ezer Lutheran Brush, CO 80723 Englewood Post Englewood, CO 80110 Four Corners Health Durango, CO 81301

Case ID

NATCEP Loss Eff. Date

Loss Last Day

COUVMO

10/13/2016

10/12/2018

COXOVS

3/2/2016

3/1/2018

COQL66

7/4/2017

7/3/2019

CO5OMD

9/1/2015

8/31/2017

COBWZW

7/14/2015

7/13/2017

CO9YJP

9/2/2015

9/1/2017

COYN42

8/13/2015

8/12/2017

COYOSD

3/10/2016

3/9/2018

COJC31

5/9/2017

5/8/2019

COEFK4

12/9/2015

12/8/2017

COI2UH

10/19/2016

10/18/2018

COVDCZ

4/18/2017

4/17/2019

COM8MN

11/20/2015

11/19/2017

CO7Q3U

3/8/2017

3/7/2019

COJFYT

6/1/2017

5/31/2019

CO0KPW

9/9/2017

9/8/2019

COHKKT

7/29/2016

7/28/2018

COOUPN

8/25/2015

8/24/2017

CO7K9K

6/28/2017

6/27/2019

COY9R0

6/21/2017

6/20/2019

COED8B

9/19/2015

9/18/2017

COQHQD

6/28/2016

6/27/2018

4 7/25/2017rb

Colorado Active and Potential NATCEP Loss Report August 2017 Extracted from the 07/24/2017 NATCEP Loss Report Frasier Meadows Boulder, CO 80303 Good Samaritan Loveland, CO 80537 Good Samaritan Simla, CO 80835 Gunnison Valley Gunnison, CO 81320 Hallmark Nursing Denver, CO 80236 Health Center At Denver, CO 80218 Highline Denver, CO 80222 Horizons Care Eckert, CO 81418 Juniper Village, The Denver, CO 80211 Kenton Manor Greeley, CO 80634 Kindred Nursing and Aurora, CO 80010 La Villa Grande Care Grand Junction, CO Lakewood Villa Lakewood, CO 80215 Life Care Center Colorado Springs Life Care Center Evergreen, CO 80439 Lincoln Community Hugo, CO 80821 Longmont United Longmont, CO 80501 Manorcare Health Denver, CO 80224 Mantey Heights Grand Junction, CO Mesa Manor Center Grand Junction, CO Mission San Miguel Commerce City, CO Monaco Parkway Denver, CO 80224 Monte Vista Estates Monte Vista, CO 81144 Mountain Vista Wheat Ridge, CO 80033 Mountain Vista Wheat Ridge, CO 80033 Mountain Vista Wheat Ridge, CO 80033

CO61M4

5/7/2017

5/6/2019

COQMCJ

6/14/2017

6/13/2019

CO4GDO

3/30/2016

3/29/2018

COZILT

10/28/2016

10/27/2018

COME4Y

11/27/2015

11/26/2017

COYBOC

1/20/2016

1/19/2018

CO8FLT

12/24/2015

12/23/2017

CO2CY8

1/20/2016

1/19/2018

CO6T0T

5/17/2016

5/16/2018

COB1EH

12/23/2015

12/22/2017

COG4BH

6/9/2016

6/8/2018

COQOSJ

12/29/2016

12/28/2018

COMEUT

5/31/2017

5/30/2019

CO6VG0

1/22/2016

1/21/2018

COLO6F

7/20/2017

7/19/2019

COZ0C3

6/29/2017

6/28/2019

CODKT1

8/1/2017

7/31/2019

COMMPR

10/22/2016

10/21/2018

COOLU4

3/2/2017

3/1/2019

COLE5B

4/14/2016

4/13/2018

CO73SD

5/10/2017

5/9/2019

COBR1C

7/21/2017

7/20/2019

COXJB1

6/8/2017

6/7/2019

CO9MX2

2/19/2016

2/18/2018

COELOR

1/20/2016

1/19/2018

COKZ1Q

9/22/2016

9/21/2018

5 7/25/2017rb

Colorado Active and Potential NATCEP Loss Report August 2017 Extracted from the 07/24/2017 NATCEP Loss Report Orchard Park Health Littleton, CO 80121 Orchard Park Health Littleton, CO 80121 Palisades Living Palisade, CO 81526 Powerback Lakewood, CO 80227 Powerback Lakewood, CO 80227 Regent Park Nursing Holyoke, CO 80734 Rehabilitation Wheat Ridge, CO 80033 Rehabilitation and Ft. Collins, CO Rock Canyon Pueblo, CO 81004 San Juan Living Montrose, CO 81401 Sierra Vista Loveland, CO 80537 Skyline Ridge Canon City, CO 81212 Sunset Manor Brush, CO 80723

COTKP7

12/11/2015

12/20/2017

CO7Y5J

6/28/2017

6/27/2019

CO4WSY

6/10/2017

6/9/2019

COZ95S

9/10/2016

9/9/2018

COIFCT

9/30/2015

9/29/2017

COLJTE

6/23/2017

6/22/2019

COBW8Z

2/18/2017

2/17/2019

COUVP7

8/5/2017

8/4/2019

COBWSY

6/15/2016

6/14/2018

COSOLG

7/6/2017

7/5/2019

CO1PUM

10/11/2016

10/10/2018

COCD0K

8/1/2015

7/31/2017

CORYL3

4/21/2017

4/20/2019

The current list of facilities restricted from participation in nurse aide training can be found at: http://cdn.colorado.gov/cs/Satellite?c=Page&childpagename=DORAReg%2FDORALayout&cid=1251632510449&pagename=CBONWrapper

6 7/25/2017rb

Facilities Restricted from Participation in Nurse Aide Training.pdf ...

University Park Care. Pueblo, CO 81001. COKSBD 12/20/2016 12/19/2018. Uptown Health Care. Denver, CO 80203. CONPBY 11/21/2016 11/20/2018.

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