Lifestream At Sun Ridge - Surprise Nursing Home
General Information
UPDATEFederal Provider Number
35243
Provider Name
LIFESTREAM AT SUN RIDGE
Provider Address
12215 WEST BELL ROAD
SURPRISE, AZ 85374
SURPRISE, AZ 85374
Provider Phone Number
(623) 583-5482
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
58
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1997-08-04
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
1.72358
Reported LPN Staffing Hours per Resident per Day
0.78962
Reported RN Staffing Hours per Resident per Day
0.47453
Reported Licensed Staffing Hours per Resident per Day
1.26415
Reported Total Nurse Staffing Hours per Resident per Day
2.98773
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02453
Expected CNA Staffing Hours per Resident per Day
2.47941
Expected LPN Staffing Hours per Resident per Day
0.61604
Expected RN Staffing Hours per Resident per Day
0.83359
Expected Total Nurse Staffing Hours per Resident per Day
3.92904
Adjusted CNA Staffing Hours per Resident per Day
1.70570
Adjusted LPN Staffing Hours per Resident per Day
1.06387
Adjusted RN Staffing Hours per Resident per Day
0.42535
Adjusted Total Nurse Staffing Hours per Resident per Day
3.06519
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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