Arizona State Veteran Home-phx - Phoenix Nursing Home
General Information
UPDATEFederal Provider Number
35234
Provider Name
ARIZONA STATE VETERAN HOME-PHX
Provider Address
4141 NORTH S HERRERA WAY
PHOENIX, AZ 85012
PHOENIX, AZ 85012
Provider Phone Number
(602) 248-1550
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
200
Number of Residents in Certified Beds
172
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNIVERSITY OF ARIZONA
Date First Approved to Provide Medicare and Medicaid services
1996-01-08
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.52791
Reported LPN Staffing Hours per Resident per Day
1.04622
Reported RN Staffing Hours per Resident per Day
0.60814
Reported Licensed Staffing Hours per Resident per Day
1.65436
Reported Total Nurse Staffing Hours per Resident per Day
4.18227
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02733
Expected CNA Staffing Hours per Resident per Day
2.31228
Expected LPN Staffing Hours per Resident per Day
0.60288
Expected RN Staffing Hours per Resident per Day
0.88095
Expected Total Nurse Staffing Hours per Resident per Day
3.79611
Adjusted CNA Staffing Hours per Resident per Day
2.68252
Adjusted LPN Staffing Hours per Resident per Day
1.44036
Adjusted RN Staffing Hours per Resident per Day
0.51581
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44094
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-01-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2012-12-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2011-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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