Grace Healthcare Of Phoenix - Phoenix Nursing Home
General Information
UPDATEFederal Provider Number
35107
Provider Name
GRACE HEALTHCARE OF PHOENIX
Provider Address
4202 NORTH 20TH AVENUE
PHOENIX, AZ 85015
PHOENIX, AZ 85015
Provider Phone Number
(602) 264-3824
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PHOENIX HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
1985-06-24
Continuing Care Retirement Community
N
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.84728
Reported LPN Staffing Hours per Resident per Day
0.77826
Reported RN Staffing Hours per Resident per Day
0.50000
Reported Licensed Staffing Hours per Resident per Day
1.27826
Reported Total Nurse Staffing Hours per Resident per Day
3.12554
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06141
Expected CNA Staffing Hours per Resident per Day
2.50178
Expected LPN Staffing Hours per Resident per Day
0.75064
Expected RN Staffing Hours per Resident per Day
1.19524
Expected Total Nurse Staffing Hours per Resident per Day
4.44766
Adjusted CNA Staffing Hours per Resident per Day
1.81178
Adjusted LPN Staffing Hours per Resident per Day
0.86055
Adjusted RN Staffing Hours per Resident per Day
0.31257
Adjusted Total Nurse Staffing Hours per Resident per Day
2.83267
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
222
Cycle 1 Standard Survey Health Date
2014-04-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
222
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-02-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-12-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
129.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
59700
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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