Mi Casa Nursing Center - Mesa Nursing Home
General Information
UPDATEFederal Provider Number
35120
Provider Name
MI CASA NURSING CENTER
Provider Address
330 SOUTH PINNULE CIRCLE
MESA, AZ 85206
MESA, AZ 85206
Provider Phone Number
(480) 981-0687
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
180
Number of Residents in Certified Beds
130
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MESA UNITED MEDICAL INVESTORS LIMITED PARTNERSHIP
Date First Approved to Provide Medicare and Medicaid services
1985-11-27
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
2
Overall Rating Footnote
Health Inspection Rating
3
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
1.91846
Reported LPN Staffing Hours per Resident per Day
0.91423
Reported RN Staffing Hours per Resident per Day
0.60231
Reported Licensed Staffing Hours per Resident per Day
1.51654
Reported Total Nurse Staffing Hours per Resident per Day
3.43500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15538
Expected CNA Staffing Hours per Resident per Day
2.61216
Expected LPN Staffing Hours per Resident per Day
0.76644
Expected RN Staffing Hours per Resident per Day
1.34469
Expected Total Nurse Staffing Hours per Resident per Day
4.72329
Adjusted CNA Staffing Hours per Resident per Day
1.80208
Adjusted LPN Staffing Hours per Resident per Day
0.99005
Adjusted RN Staffing Hours per Resident per Day
0.33468
Adjusted Total Nurse Staffing Hours per Resident per Day
2.93146
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-12-05
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-11-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
33.33300
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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