The Health Care Center-forum Tucson - Tucson Nursing Home

General Information

UPDATE
Federal Provider Number
35199
Provider Name
THE HEALTH CARE CENTER-FORUM TUCSON
Provider Address
2500 NORTH ROSEMONT BOULEVARD
TUCSON, AZ 85712
Provider Phone Number
(520) 795-7892
Provider SSA County
90
Provider County Name
Pima
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR TUCSON FORUM LLC
Date First Approved to Provide Medicare and Medicaid services
1990-01-05
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.35227
Reported LPN Staffing Hours per Resident per Day
1.45909
Reported RN Staffing Hours per Resident per Day
0.68977
Reported Licensed Staffing Hours per Resident per Day
2.14886
Reported Total Nurse Staffing Hours per Resident per Day
4.50113
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18864
Expected CNA Staffing Hours per Resident per Day
2.16535
Expected LPN Staffing Hours per Resident per Day
0.63852
Expected RN Staffing Hours per Resident per Day
1.38411
Expected Total Nurse Staffing Hours per Resident per Day
4.18799
Adjusted CNA Staffing Hours per Resident per Day
2.66551
Adjusted LPN Staffing Hours per Resident per Day
1.89663
Adjusted RN Staffing Hours per Resident per Day
0.37237
Adjusted Total Nurse Staffing Hours per Resident per Day
4.33229
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
184
Cycle 1 Standard Survey Health Date
2014-09-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
184
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-06-12
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-03-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
102.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
47350
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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