The Health Care Center-forum Tucson
2500 North Rosemont Boulevard, Tucson, AZ 85712


The Health Care Center-forum Tucson is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 035199. The address is 2500 North Rosemont Boulevard, Tucson, AZ 85712. The zip code is 85712. The phone number is 5207957892.


The Health Care Center-forum Tucson · 2500 North Rosemont Boulevard, Tucson, AZ 85712

Federal Provider Number 035199
Provider Name THE HEALTH CARE CENTER-FORUM TUCSON
Address 2500 NORTH ROSEMONT BOULEVARD
TUCSON, AZ 85712
Phone Number 5207957892
SSA County Code 90
County Name Pima
Ownership Type For profit - Corporation
Certified Beds 67
Certified Beds Residents 20
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name FIVE STAR TUCSON FORUM LLC
Date First Approved to Provide Medicare Medicaid Services 01/05/1990
Continuing Care Retirement Community true
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 3.17
Reported LPN Staffing Hours per Resident per Day 1.895
Reported RN Staffing Hours per Resident per Day 2.195
Reported Licensed Staffing Hours per Resident per Day 4.09
Reported Total Nurse Staffing Hours per Resident per Day 7.26
Reported Physical Therapist Staffing Hours per Resident Per Day 0.4975
Expected CNA Staffing Hours per Resident per Day 2.39578
Expected LPN Staffing Hours per Resident per Day 0.73456
Expected RN Staffing Hours per Resident per Day 1.49095
Expected Total Nurse Staffing Hours per Resident per Day 4.62129
Adjusted CNA Staffing Hours per Resident per Day 3.24664
Adjusted LPN Staffing Hours per Resident per Day 2.1412
Adjusted RN Staffing Hours per Resident per Day 1.10004
Adjusted Total Nurse Staffing Hours per Resident per Day 6.3325
Cycle 1 Standard Survey Health Date 02/08/2017
Cycle 2 Total Number of Health Deficiencies 5
Cycle 2 Number of Standard Health Deficiencies 4
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 44
Cycle 2 Standard Health Survey Date 11/18/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 44
Cycle 3 Total Number of Health Deficiencies 15
Cycle 3 Number of Standard Health Deficiencies 12
Cycle 3 Number of Complaint Health Deficiencies 8
Cycle 3 Health Deficiency Score 208
Cycle 3 Standard Health Survey Date 09/15/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 208
Total Weighted Health Survey Score 49.333
Number of Substantiated Complaints 6
Number of Fines 1
Total Amount of Fines in Dollars $47350.00
Number of Payment Denials 2
Total Number of Penalties 3
Processing Date 08/01/2017

Owner or Manager · The Health Care Center-forum Tucson

Owner Name Role Association Date
BLACKROCK INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
7%
since 12/31/2015
CHELLEL, SANDRA (Individual) MANAGING EMPLOYEE since 03/09/2015
CLARK, JENNIFER (Individual) OFFICER since 09/01/2009
DIMENSIONAL FUND ADVISORS LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
7%
since 12/31/2015
DOYLE, RICHARD (Individual) OFFICER since 01/01/2016
FINKLE, JENNIFER (Individual) MANAGING EMPLOYEE since 07/21/2016
FIVE STAR QUALITY CARE INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2009
FSQ INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2009
HERZIG, ROBERT (Individual) OFFICER since 11/07/2012
LACE, HILLARY (Individual) MANAGING EMPLOYEE since 03/07/2016
MACKEY, BRUCE (Individual) OFFICER since 09/01/2009
MARTIN, GERARD (Individual) DIRECTOR since 09/01/2009
MARZELLI, ANTHONY (Individual) MANAGING EMPLOYEE since 01/01/2011
PORTNOY, BARRY (Individual) DIRECTOR since 09/01/2009
POTTER, KATHERINE (Individual) OFFICER since 02/27/2012
SENIOR HOUSING PROPERTIES TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
9%
since 12/31/2015

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Tucson · Nursing Home

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Mountain View Care Center 1313 West Magee Road, Tucson, AZ 85704
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Park Avenue Health and Rehabilitation Center 2001 North Park Avenue, Tucson, AZ 85719
Sante of Tucson 2040 North Wilmot Road, Tucson, AZ 85712
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Maryland Gardens Care Center 31 West Maryland Avenue, Phoenix, AZ 85013
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The Legacy Rehab & Care Center 2812 Silver Creek Road, Bullhead City, AZ 86442
Plaza Healthcare 1475 North Granite Reef Road, Scottsdale, AZ 85257
Casas Adobes Post Acute Rehab Center 1919 West Medical Street, Tucson, AZ 85704
Santa Rosa Care Center 1650 North Santa Rosa Avenue, Tucson, AZ 85712
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Fountain View Village 16455 East Avenue of The Fountains, Fountain Hills, AZ 85268
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