SNF

SURPRISE HEALTH AND REHABILITATION CENTER

CCN: 035297 · SURPRISE, AZ 85374 · Maricopa County

Overview

Address
14660 WEST PARKWOOD DRIVE, SURPRISE, AZ 85374
Phone
6235465030
Certified beds
100
Avg daily residents
100 (100% of beds filled)
Ownership
For-profit corporation
Provider type
Medicare
Medicare/Medicaid since
2019-10-04
Setting
Urban
5 /5
★★★★★
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
★★★★★ 5/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
★★★★★ 5/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
★★★★★ 2/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
★★★★★ 5/5
Quality Measures breakdown
Long-Stay Quality Measures ★★★★★ 5/5
Short-Stay Quality Measures ★★★★★ 5/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 5.09 6.49 3.03 ≥ 3.48
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.90 1.14 0.54 ≥ 0.55
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 1.48 1.44 0.88 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 2.71 3.91 1.61 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 2.38 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.16 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
4.24
hrs / resident / day
RN (weekend)
0.67
hrs / resident / day
Total nurse (adjusted, weekend)
2.52
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
51.0%
annual
RN turnover
55.0%
annual
Administrators departed
0
last 12 months

Resident acuity

Nursing Case-Mix Index
2.30
higher acuity than avg
Case-Mix Index Ratio
1.67
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2024-04-12 2 0 2 8 0 8
Cycle 2/3 (prior) 2022-12-23 3 2 1 16 1 16
Total weighted health score
10.0
lower is better

Deficiencies (11)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

11 D/E/F Actual harm — potential for minor
Tag Description Scope/Severity Survey date Corrected
0698 Provide safe, appropriate dialysis care/services for a resident who requires such services. D 2025-03-11 2025-04-18
0836 Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. D 2025-03-06 2025-03-19
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. D 2024-06-27 2024-08-13
0554 Allow residents to self-administer drugs if determined clinically appropriate. E 2022-12-23 2023-01-23
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. D 2022-12-23 2023-01-23
0578 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. D 2021-11-04 2021-12-06
0641 Ensure each resident receives an accurate assessment. E 2021-11-04 2021-12-06
0658 Ensure services provided by the nursing facility meet professional standards of quality. E 2021-11-04 2021-12-06
0695 Provide safe and appropriate respiratory care for a resident when needed. D 2021-11-04 2021-12-06
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. D 2021-11-04 2021-12-06
0880 Provide and implement an infection prevention and control program. D 2021-11-04 2021-12-06

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 26.4% Medicaid 25.3% Other 48.3%

Operating performance

Operating Margin
14.3%
Total Margin
14.5%
Occupancy Rate
94.6%
Cost per Resident Day
$147

Revenue & costs

Net Patient Revenue
$22.2M
Total Costs
$5.1M
Net Income
$3.2M

Balance sheet

Total Assets
$8.8M
Total Liabilities
$692K
Fund Balance
$8.1M
Current Ratio
11.82

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: THE ENSIGN GROUP

Chain ID
507
Facilities in chain
329
Legal business name
LUDDEN HEALTHCARE LLC
Chain-average star ratings (for peer context)
Overall
3.2
Health
2.9
Staffing
2.7
QM
4.3

Owner / manager organizations (2)

Organization Role Association
BANDERA HEALTHCARE LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 06/07/2019
THE ENSIGN GROUP INC 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 08/01/2019

Owner / manager individuals (8)

Name Role Association
GLAZIER, MARK OPERATIONAL/MANAGERIAL CONTROL since 08/01/2019
PETERSON, FORREST CORPORATE DIRECTOR since 08/01/2019
BURNAM, SOON CORPORATE OFFICER since 06/07/2019
FITCH, CRAIG CORPORATE OFFICER since 06/07/2019
LORENZ, BRIAN CORPORATE OFFICER since 06/07/2019
PETERSON, FORREST CORPORATE OFFICER since 08/01/2019
SNAPPER, SUZANNE CORPORATE OFFICER since 08/07/2009
GLAZIER, MARK W-2 MANAGING EMPLOYEE since 08/01/2019

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Both
Sprinkler systems
Yes
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 113 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $147 metrics.cost_per_resident_day
Cost Report Current Ratio 11.82 metrics.current_ratio
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 25.3% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 26.4% metrics.medicare_day_share
Cost Report Net Income ($) $3,221,328 metrics.net_income
Cost Report Net Patient Revenue ($) $22,208,086 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 94.6% metrics.occupancy_rate
Cost Report Operating Margin (%) 14.3% metrics.operating_margin
Cost Report Total Assets ($) $8,750,161 metrics.total_assets
Cost Report Total Costs ($) $5,087,747 metrics.total_costs
Cost Report Total Fund Balances ($) $8,057,852 metrics.fund_balance
Cost Report Total Liabilities ($) $692,309 metrics.total_liabilities
Cost Report Total Margin (%) 14.5% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 0.87998 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 1.61493 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.53591 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.03083 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 2.52009 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote — Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 100.3 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 1.44013 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 3.91395 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 1.13514 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 6.48921 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 5.71956 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 2.9 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 3.2 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 4.3 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 2.7 Chain Average Staffing Rating
Provider Information Chain ID 507 Chain ID
Provider Information Chain Name THE ENSIGN GROUP Chain Name
Provider Information City/Town SURPRISE City/Town
Provider Information CMS Certification Number (CCN) 035297 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Maricopa County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 2019-10-04 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating 5 Health Inspection Rating
Provider Information Health Inspection Rating Footnote — Health Inspection Rating Footnote
Provider Information Latitude 33.6488 Latitude
Provider Information Legal Business Name LUDDEN HEALTHCARE LLC Legal Business Name
Provider Information Location 14660 WEST PARKWOOD DRIVE,SURPRISE,AZ,85374 Location
Provider Information Long-Stay QM Rating 5 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote — Long-Stay QM Rating Footnote
Provider Information Longitude -112.38 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 0 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 100 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections — Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 329 Number of Facilities in Chain
Provider Information Number of Fines 0 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 2.29884 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 1.66867 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 5 Overall Rating
Provider Information Overall Rating Footnote — Overall Rating Footnote
Provider Information Ownership Type For profit - Corporation Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 14660 WEST PARKWOOD DRIVE Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name SURPRISE HEALTH AND REHABILITATION CENTER Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 060 Provider SSA County Code
Provider Information Provider Type Medicare Provider Type
Provider Information QM Rating 5 QM Rating
Provider Information QM Rating Footnote — QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 8 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 2 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 0 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 0 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2024-04-12 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 8 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 2 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 2 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2022-12-23 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 16 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 1 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 16 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 3 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.66605 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 55.0 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote — Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 2.37976 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 1.47903 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 2.71429 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.16283 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.90073 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 5.09404 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 5 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote — Short-Stay QM Rating Footnote
Provider Information Special Focus Status — Special Focus Status
Provider Information Staffing Rating 2 Staffing Rating
Provider Information Staffing Rating Footnote — Staffing Rating Footnote
Provider Information State AZ State
Provider Information Telephone Number 6235465030 Telephone Number
Provider Information Total Amount of Fines in Dollars 0.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 4.23561 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 0 Total Number of Penalties
Provider Information Total nursing staff turnover 51.0 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote — Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 10.000 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Both With a Resident and Family Council
Provider Information ZIP Code 85374 ZIP Code