Health Care Ctr At The Forum At Rancho San Antonio - Cupertino Nursing Home
General Information
UPDATEFederal Provider Number
555524
Provider Name
HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO
Provider Address
23600 VIA ESPLENDOR
CUPERTINO, CA 95014
CUPERTINO, CA 95014
Provider Phone Number
6509440280
Provider SSA County
530
Provider County Name
Santa Clara
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
39
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
RANCHO SAN ANTONIO RETIREMENT SERVICES, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-09-01
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.94872
Reported LPN Staffing Hours per Resident per Day
0.44359
Reported RN Staffing Hours per Resident per Day
1.48333
Reported Licensed Staffing Hours per Resident per Day
1.92692
Reported Total Nurse Staffing Hours per Resident per Day
4.87564
Reported Physical Therapist Staffing Hours per Resident Per Day
0.33333
Expected CNA Staffing Hours per Resident per Day
2.43084
Expected LPN Staffing Hours per Resident per Day
0.59857
Expected RN Staffing Hours per Resident per Day
1.05387
Expected Total Nurse Staffing Hours per Resident per Day
4.08328
Adjusted CNA Staffing Hours per Resident per Day
2.97645
Adjusted LPN Staffing Hours per Resident per Day
0.61510
Adjusted RN Staffing Hours per Resident per Day
1.05169
Adjusted Total Nurse Staffing Hours per Resident per Day
4.81310
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-04-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
32
Cycle 2 Standard Health Survey Date
2013-05-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
20.00000
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
Nursiong Homes Nearby
Los Altos Sub-acute And Rehabilitation Center
809 Fremont Avenue |
LOS ALTOS CA 94024 | 1.3 miles away
Sunny View Manor
22445 Cupertino Road |
CUPERTINO CA 95014 | 1.6 miles away
Cupertino Healthcare & Wellness Center
22590 Voss Avenue |
CUPERTINO CA 95014 | 1.8 miles away
Sunnyvale Health Care Center
1291 S Bernardo Avenue |
SUNNYVALE CA 94087 | 1.9 miles away
Mountain View Healthcare Center
2530 Solace Place |
MOUNTAIN VIEW CA 94040 | 2 miles away
Idylwood Care Center
1002 W. Fremont Avenue |
SUNNYVALE CA 94087 | 2 miles away
Villa Siena
1855 Miramonte Avenue |
MOUNTAIN VIEW CA 94040 | 2.2 miles away
Grant Cuesta Sub-acute And Rehabilitation Center
1949 Grant Road |
MOUNTAIN VIEW CA 94040 | 2.5 miles away
Manorcare Health Services (sunnyvale)
1150 Tilton Drive |
SUNNYVALE CA 94087 | 3.3 miles away
Cedar Crest Nursing And Rehabilitation Center
797 E Fremont Avenue |
SUNNYVALE CA 94087 | 4 miles away
The Terraces At Los Altos Health Facility
373 Pine Lane |
LOS ALTOS CA 94022 | 4.2 miles away
Amberwood Gardens
1601 Petersen Avenue |
SAN JOSE CA 95129 | 5.8 miles away
Our Lady Of Fatima Villa
20400 Saratoga-los Gatos Rd |
SARATOGA CA 95070 | 6.5 miles away
Courtyard Care Center
340 Northlake Drive |
SAN JOSE CA 95117 | 6.7 miles away
Subacute/saratoga
13425 Sousa Lane |
SARATOGA CA 95070 | 6.8 miles away
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