The Forum At Brookside
The Forum At Brookside Information
| Facility Name | The Forum At Brookside |
| Location | 200 Brookside Drive, Louisville, KY 40243 |
| County (SSA Code) | Jefferson (550) |
| Phone Number | 502-245-3048 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 40 |
| Average Number of Residents | 30.2 |
| CCRC Facility? | Yes |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | SNH DERBY TENANT LLC |
| Ownership Type | For profit - Corporation |
| Date First Approved | 1991-04-30 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 3.90986 |
| Reported LPN Staffing Hours per Resident per Day | 0.86216 |
| Reported RN Staffing - Hours per Resident per Day | 1.80185 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.66401 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 6.57387 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.10028 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.20373 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.73751 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.44281 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.38405 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 6.19339 |
| Total Weighted Health Survey Score for three cycles | 26.833 |
| Rating cycle 1 Standard Survey Health Date | 2019-05-01 |
| Rating cycle 1 - Total Health Inspection Score | 12 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-03-05 |
| Rating cycle 2 - Health Deficiency Score | 12 |
| Date of Rating cycle 3 Standard Health Survey Date | 2016-12-07 |
| Rating cycle 3 - Health Deficiency Score | 137 |
| Rating cycle 3 - Total Health Inspection Score | 137 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Substantiated Complaints | 0 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |