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Health Care Center at The Forum at Rancho San Antonio
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Health Care Center at The Forum at Rancho San Antonio Share
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Overview Share
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Cupertino, California
Medicare

Health Care Center at The Forum at Rancho San Antonio is a nursing home located in Cupertino, California with 48 beds and an average of 44 residents per day.

Address
23600 Via Esplendor
Cupertino, California 95014
Contact
Scoreboard
Overall:
Health inspection:
Quality measures:
Long-term stay quality measures:
Short-term stay quality measures:
Staffing:
Nurse staffing:
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Facts & features Share
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Continuing care retirement community: Yes
Automatic sprinkler systems: Yes
Council: Family and resident council
Provider type: Medicare
Date first approved to provide Medicare and Medicaid services: September 1, 1992
Number of beds: 48
Number of residents per day: 44
Percent of beds that are filled: 92% of beds are filled
Health inspection Share
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Health inspection rating

Health inspection ratings are based on the number, scope, and severity of deficiencies identified during the three most recent annual inspection surveys, as well as substantiated findings from the most recent 36 months of complaint investigations. All deficiency findings are weighted by scope and severity. This measure also takes into account the number of revisits required to ensure that deficiencies identified during the health inspection survey have been corrected.

Number of health deficiencies by year

A health citation is a finding that a nursing home failed to meet one or more federal health requirements during an annual health inspection or a complaint inspection. Inspectors identify health citations by observing the nursing home's performance, its practices, or the conditions in the facility.

2019 3
2018 5
2017 2
Learn more about health inspection ratings
Staff Share
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Staff rating
Nurse staff rating

Staff ratings are based on nursing home staffing levels. They are based on two measures: (1) Registered nurse hours per resident per day and (2) Total nurse staffing (registered nurses, licensed practical nurses, and nurse aides) hours per resident per day.

Higher staffing hours per resident per day means that each resident receives more hours of care.

At Health Care Center at The Forum at Rancho San Antonio, residents receive around 4.5 hours of care each day.

Nurse staffing hours per resident per day
Nurse aid staffing hours per resident per day 2.7 hours
Licensed practical nurse hours per resident per day 0.6 hours
Registered nurse staffing hours per resident per day 1.4 hours
Total nurse staffing hours per resident per day 4.5 hours
Quality of care Share
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Overall quality of care rating
Long-term stay quality of care rating
Short-term stay quality of care rating

The quality of care rating is based on a variety of measures including:

Percent of residents whose need for help with activities of daily living has increased
Percent of residents whose ability to move independently worsened
Percent of high-risk residents with pressure ulcers
Percent of residents who have/had a catheter inserted and left in their bladder
Percent of residents with a urinary tract infection
Percent of residents experiencing one or more falls with major injury
Percent of residents who received an antipsychotic medication
Number of hospitalizations
Number of outpatient emergency department visits
Management Share
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Health Care Center at The Forum at Rancho San Antonio is operated by Rancho San Antonio Retirement Services, Inc. It was first approved to provide Medicare and Medicaid services on September 1, 1992.
Ownership
Name Role Ownership percentage Association date

Lois Adams

Individual
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Director Not Applicable Since 06/01/2013

Lois Adams

Individual
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Officer Not Applicable Since 01/28/2015

Mehrdad Ayati

Individual
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Director Not Applicable Since 12/31/2018

Vernon Clifford

Individual
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Director Not Applicable Since 02/28/2018

Vernon Clifford

Individual
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Officer Not Applicable Since 02/28/2018

Jerome Fischbein

Individual
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Director Not Applicable Since 01/01/2014

Nancy Kao

Individual
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Operational/Managerial Control Not Applicable Since 06/01/2012

Lynda Kaser

Individual
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Operational/Managerial Control Not Applicable Since 09/04/2012

Life Care Services LLC

Organization
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Operational/Managerial Control Not Applicable Since 06/01/2012

Rancho San Antonio Retirement Housing Corporation

Organization
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5% Or Greater Direct Ownership Interest 100% Since 07/02/1999

Inc. Rancho San Antonio Retirement Services

Organization
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Operational/Managerial Control Not Applicable Since 06/29/1988

Edith Tousey

Individual
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Director Not Applicable Since 12/31/2018

Mildred Vasan

Individual
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Officer Not Applicable Since 01/23/2019

Mildred Vasan

Individual
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Director Not Applicable Since 01/01/2016

Lily Young

Individual
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Officer Not Applicable Since 01/01/2016

Lily Young

Individual
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Director Not Applicable Since 01/28/2015
Incidents and fines Share
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Number of facility reported incidents 0
Number of substantiated complaints 0
Number of fines 0
Total fines $0
Number of payment denials 0
Number of penalties 0
Nearby Share
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Test Share
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Federal Provider Number 555524
Ownership Type
Special Focus Status
Abuse Icon
Most Recent Health Inspection More Than 2 Years Ago
Provider Changed Ownership in Last 12 Months
Overall Rating 5
Health Inspection Rating 5
QM Rating 5
Long-Stay QM Rating 5
Short-Stay QM Rating 5
Staffing Rating 5
RN Staffing Rating 5

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