Lifestream At Sun Ridge
12215 West Bell Road, Surprise, AZ 85378


Lifestream At Sun Ridge is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 035243. The address is 12215 West Bell Road, Surprise, AZ 85378. The zip code is 85378. The phone number is 6235835482.


Lifestream At Sun Ridge · 12215 West Bell Road, Surprise, AZ 85378

Federal Provider Number 035243
Provider Name LIFESTREAM AT SUN RIDGE
Address 12215 WEST BELL ROAD
SURPRISE, AZ 85378
Phone Number 6235835482
SSA County Code 60
County Name Maricopa
Ownership Type For profit - Corporation
Certified Beds 58
Certified Beds Residents 47
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE INC
Date First Approved to Provide Medicare Medicaid Services 08/04/1997
Continuing Care Retirement Community false
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 3
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.20957
Reported LPN Staffing Hours per Resident per Day 0.94681
Reported RN Staffing Hours per Resident per Day 0.45
Reported Licensed Staffing Hours per Resident per Day 1.39681
Reported Total Nurse Staffing Hours per Resident per Day 3.60638
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02234
Expected CNA Staffing Hours per Resident per Day 2.59041
Expected LPN Staffing Hours per Resident per Day 0.57435
Expected RN Staffing Hours per Resident per Day 0.81276
Expected Total Nurse Staffing Hours per Resident per Day 3.97752
Adjusted CNA Staffing Hours per Resident per Day 2.09296
Adjusted LPN Staffing Hours per Resident per Day 1.36824
Adjusted RN Staffing Hours per Resident per Day 0.4137
Adjusted Total Nurse Staffing Hours per Resident per Day 3.65478
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 4
Cycle 1 Standard Survey Health Date 01/20/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 4
Cycle 2 Total Number of Health Deficiencies 11
Cycle 2 Number of Standard Health Deficiencies 11
Cycle 2 Health Deficiency Score 60
Cycle 2 Standard Health Survey Date 12/09/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 60
Cycle 3 Total Number of Health Deficiencies 7
Cycle 3 Number of Standard Health Deficiencies 7
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 32
Cycle 3 Standard Health Survey Date 10/30/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 32
Total Weighted Health Survey Score 27.333
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Lifestream At Sun Ridge

Owner Name Role Association Date
BOLZE, ERIC (Individual) DIRECTOR since 03/22/2016
DICKSON, WILLIAM (Individual) DIRECTOR since 08/04/1997
ESTES, RONALD (Individual) OFFICER since 01/30/2013
HARP, DARWYN (Individual) DIRECTOR since 09/19/2013
HOWELL, KENNETH (Individual) DIRECTOR since 01/01/2015
KIDDER, DEAN (Individual) MANAGING EMPLOYEE since 12/16/2016
KORTMAN, KEN (Individual) DIRECTOR since 08/04/1997
LIFESTREAM COMPLETE SENIOR LIVING INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 08/04/1997
TAYLOR, DONNA (Individual) OFFICER since 08/04/1997
WISELY, TAMARA (Individual) DIRECTOR since 03/18/2013

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