Providence Place At Glencroft - Glendale Nursing Home
General Information
UPDATEFederal Provider Number
35154
Provider Name
PROVIDENCE PLACE AT GLENCROFT
Provider Address
8641 NORTH 67TH AVE
GLENDALE, AZ 85302
GLENDALE, AZ 85302
Provider Phone Number
(623) 939-9475
Provider SSA County
60
Provider County Name
Maricopa
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
225
Number of Residents in Certified Beds
157
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRIENDSHIP RETIREMENT CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1988-04-05
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.71465
Reported LPN Staffing Hours per Resident per Day
1.13535
Reported RN Staffing Hours per Resident per Day
0.60669
Reported Licensed Staffing Hours per Resident per Day
1.74204
Reported Total Nurse Staffing Hours per Resident per Day
4.45669
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01911
Expected CNA Staffing Hours per Resident per Day
2.39608
Expected LPN Staffing Hours per Resident per Day
0.63960
Expected RN Staffing Hours per Resident per Day
1.00931
Expected Total Nurse Staffing Hours per Resident per Day
4.04500
Adjusted CNA Staffing Hours per Resident per Day
2.77993
Adjusted LPN Staffing Hours per Resident per Day
1.47333
Adjusted RN Staffing Hours per Resident per Day
0.44914
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44116
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-02-25
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-12-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
10.00000
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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