Health Care Ctr At The Forum At Rancho San Antonio
Health Care Ctr At The Forum At Rancho San Antonio Information
| Facility Name | Health Care Ctr At The Forum At Rancho San Antonio |
| Location | 23600 Via Esplendor, Cupertino, CA 95014 |
| County (SSA Code) | Santa Clara (530) |
| Phone Number | 650-944-0200 |
| Certification(s) | Medicare |
| Number of Beds | 48 |
| Average Number of Residents | 39 |
| 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 | Both |
| Provider Business Name | RANCHO SAN ANTONIO RETIREMENT SERVICES, INC. |
| Ownership Type | Non profit - Other |
| Date First Approved | 1992-09-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 3.21728 |
| Reported LPN Staffing Hours per Resident per Day | 0.63719 |
| Reported RN Staffing - Hours per Resident per Day | 1.51191 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.1491 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 5.36639 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.12464 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.22226 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.65817 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.29679 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.17723 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 5.3849 |
| Total Weighted Health Survey Score for three cycles | 20 |
| Rating cycle 1 Standard Survey Health Date | 2019-05-03 |
| Rating cycle 1 - Health Deficiency Score | 3 |
| Rating cycle 1 - Total Health Inspection Score | 28 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-03-28 |
| Rating cycle 2 - Health Deficiency Score | 28 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-04-07 |
| Rating cycle 3 - Health Deficiency Score | 16 |
| Rating cycle 3 - Total Health Inspection Score | 16 |
| 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 |