Forum At Desert Harbor, The - Peoria Nursing Home
General Information
UPDATEFederal Provider Number
35201
Provider Name
FORUM AT DESERT HARBOR, THE
Provider Address
13840 NORTH DESERT HARBOR DRIVE
PEORIA, AZ 85381
PEORIA, AZ 85381
Provider Phone Number
(623) 972-0995
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
32
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR DESERT HARBOR LLC
Date First Approved to Provide Medicare and Medicaid services
1990-02-15
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
1.91563
Reported LPN Staffing Hours per Resident per Day
0.81875
Reported RN Staffing Hours per Resident per Day
1.08438
Reported Licensed Staffing Hours per Resident per Day
1.90313
Reported Total Nurse Staffing Hours per Resident per Day
3.81876
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12344
Expected CNA Staffing Hours per Resident per Day
2.33279
Expected LPN Staffing Hours per Resident per Day
0.67140
Expected RN Staffing Hours per Resident per Day
1.26094
Expected Total Nurse Staffing Hours per Resident per Day
4.26514
Adjusted CNA Staffing Hours per Resident per Day
2.01492
Adjusted LPN Staffing Hours per Resident per Day
1.01215
Adjusted RN Staffing Hours per Resident per Day
0.64257
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60904
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
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
36
Cycle 2 Standard Health Survey Date
2013-11-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-10-03
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
16.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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