Immanuel Campus Of Care - Peoria Nursing Home
General Information
UPDATEFederal Provider Number
35250
Provider Name
IMMANUEL CAMPUS OF CARE
Provider Address
11301 NORTH 99TH AVENUE
PEORIA, AZ 85345
PEORIA, AZ 85345
Provider Phone Number
(623) 977-8373
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
228
Number of Residents in Certified Beds
159
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
IMMANUEL CARING MINISTRIES, INC.
Date First Approved to Provide Medicare and Medicaid services
1998-11-18
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.31384
Reported LPN Staffing Hours per Resident per Day
0.96415
Reported RN Staffing Hours per Resident per Day
0.54906
Reported Licensed Staffing Hours per Resident per Day
1.51321
Reported Total Nurse Staffing Hours per Resident per Day
3.82705
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00912
Expected CNA Staffing Hours per Resident per Day
2.51691
Expected LPN Staffing Hours per Resident per Day
0.62438
Expected RN Staffing Hours per Resident per Day
0.90035
Expected Total Nurse Staffing Hours per Resident per Day
4.04164
Adjusted CNA Staffing Hours per Resident per Day
2.25573
Adjusted LPN Staffing Hours per Resident per Day
1.28166
Adjusted RN Staffing Hours per Resident per Day
0.45567
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81688
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-03-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-09-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
75.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
19
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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