Health Care Ctr At The Forum At Rancho San Antonio

23600 Via Esplendor
Cupertino, CA 95014
Santa Clara County
Phone: 650-944-0280
Provider Number: 555524
Last Inspection: 05/22/2015

About the Nursing Home About the Staff

Number of Beds
Number of
Beds
48
Number of Residents
Number of
Residents
47
Number of Beds Available
Beds Available
1
Percent Occupancy
Percent Occupancy
98%
Accepts Insurance
Insurance Accepted
Medicare
Types of Councils
Types of Councils
Both
Type of Ownership
Type of Ownership
Non profit - Other
Within a Hospital?
Within Hospital?
NO

State Inspection Deficiencies About State Inspection Deficiencies

Findings in these inspections do not present a complete picture of the quality of care provided. Information in this database should be interpreted carefully and used in conjunction with other sources, as well as a visit to the nursing home. We suggest you use our Nursing Home Checklist to help evaluate the nursing homes you plan to visit.


Deficiency Ratings what is a deficiency rating?
By Region


  • Facility
  • County
  • CA
  • USA
  • 28
  • 25
  • 31
  • 20
Lower Numbers are Better

Deficiency Ratings what is a deficiency rating?
By Year


  • 2015
  • 2014
  • 2013
  • 28
  • 7
  • 22
Lower Numbers are Better

Details by Inspection Date

 

5/22/2015 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Honor a residents' rights as a residents of the nursing home, free of coercion and reprisal, and as citizens or residents of the United States. Isolated : Minimal 3 8/26/2015
Failed To: Ensure services provided by the nursing facility meet professional standards of quality. Isolated : Minimal 3 8/26/2015
Failed To: Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated : Minimal 3 8/26/2015
Failed To: Provide food in a way that meets a resident's needs. Isolated : Minimal 3 8/26/2015
Failed To: 1) Provide 3 meals at regular times; 2) serve breakfast within 14 hours of dinner; and 3) offer a snack at bedtime each day. Pattern : Minimal 4 8/26/2015
Failed To: Store, cook, and serve food in a safe and clean way. Pattern : Minimal 4 8/26/2015
Failed To: Have a program that investigates, controls and keeps infection from spreading. Isolated : Minimal 3 8/26/2015
Failed To: Have a detailed, written plan for disasters and emergencies, such as fire, severe weather, and missing residents. Widespread : Minimal 5 8/26/2015
 

4/25/2014 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Provide housekeeping and maintenance services. Pattern : Minimal 4 5/23/2014
Failed To: Have a program that investigates, controls and keeps infection from spreading. Isolated : Minimal 3 5/23/2014
 

5/10/2013 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Isolated : Minimal 3 6/4/2013
Failed To: Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated : Minimal 3 6/4/2013
Failed To: Allow residents the right to participate in the planning or revision of care and treatment. Isolated : Minimal 3 6/4/2013
Failed To: Ensure services provided by the nursing facility meet professional standards of quality. Isolated : Minimal 3 6/4/2013
Failed To: Store, cook, and serve food in a safe and clean way. Pattern : Minimal 4 6/4/2013
Failed To: Have a program that investigates, controls and keeps infection from spreading. Isolated : Minimal 3 6/4/2013
Failed To: Train all employees on what to do in an emergency, and carry out unannounced staff drills. Isolated : Minimal 3 6/4/2013


 

About The Staff About the Staff

(Higher Numbers Are Better)

Staffing Hours Per Day Per Resident... This Facility County Avg CA State Avg
Number of Residents 47 88.92 84.73
Registered Nurses 1.16 1.02 0.87
Licensed Practical / Vocational Nurses 0.50 0.81 0.98
Certified Nursing Assistants 2.68 2.67 2.61
Total Staff Hours 4.34 4.50 4.46

About the Residents About the Staff

(Lower Numbers Are Better)

Percent of Residents... This Facility% County Avg% CA State Avg%
High Risk Long Stay Residents With Pressure Ulcers 0 5 6
Long Stay Residents Experiencing One or More Falls with Major Injury 1 1 1
Long Stay Residents Who Have Depressive Symptoms 0 1 1
Long Stay Residents Who Lose Too Much Weight 11 7 6
Long Stay Residents Who Received an Antipsychotic Medication 12 11 13
Long Stay Residents Who Self Report Moderate to Severe Pain 0 3 5
Long Stay Residents Who Were NOT Assessed and Appropriately Given the Pneumococcal Vaccine 0 2 5
Long Stay Residents Who Were NOT Assessed and Appropriately Given the Seasonal Influenza Vaccine 2 4 5
Long Stay Residents Who Were Physically Restrained 0 1 1
Long Stay Residents Whose Need for Help with ADLs has Increased 19 12 11
Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3 2 3
Long Stay Residents With a Urinary Tract Infection 9 3 3
Short Stay Residents Who Newly Received an Antipsychotic Medication 1 48 44
Short Stay Residents Who Self Report Moderate to Severe Pain 0 1 1
Short Stay Residents Who Were NOT Assessed and Appropriately Given the Pneumococcal Vaccine 0 9 12
Short Stay Residents Who Were NOT Assessed and Appropriately Given the Seasonal Influenza Vaccine 1 11 18
Short Stay Residents With Pressure Ulcers That Are New or Worsened 1 12 18