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Skilled nursing facility · CMS certification number 555524

HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO

CUPERTINO, California · Medicare · 48 certified beds in Care Compare

Download HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO’s record (CSV, each figure with its worksheet, line and column)

HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO: its citable report, full history — $295 · an email when it changes — $99/month

What stands out

  • Its latest cost report on file is for fiscal year 2024, covering January 1, 2024 to December 31, 2024 (365 days), and CMS processed it on April 28, 2025.
  • Net patient revenue rose from $16.1M in fiscal year 2023 to $21.5M in fiscal year 2024.
  • Its result from service to patients: −$9.2M (2022), −$3.6M (2023), −$2.7M (2024).
  • Its cost reports on file run from fiscal year 1996 to fiscal year 2024.
  • Its net patient revenue of $21.5M ranks 190th of the 951 nursing facilities in California whose latest cost report on file is fiscal year 2024.
  • 1 of the 5 nursing facilities in California closest in size to it, whose latest cost report on file is fiscal year 2024, also reports a loss on service to patients.

HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO: Medicare cost reports

Form CMS-2540-10: every report is settled.

Cost reports on form CMS-2540-10, fiscal years 2012 to 2024
Form CMS-2540-102024 · report 14210722023 · report 13892452022 · report 13595772021 · report 13090702020 · report 12796082019 · report 12492702018 · report 12181742017 · report 11830202016 · report 11513132015 · report 11172242014 · report 10857102013 · report 10541502012 · report 1024149
Period beganJanuary 1, 2024January 1, 2023July 1, 2022July 1, 2020July 1, 2019July 1, 2018July 1, 2017July 1, 2016July 1, 2015July 1, 2014July 1, 2013July 1, 2012July 1, 2011
Period endedDecember 31, 2024December 31, 2023December 31, 2022June 30, 2021June 30, 2020June 30, 2019June 30, 2018June 30, 2017June 30, 2016June 30, 2015June 30, 2014June 30, 2013June 30, 2012
Days, where not a full year——183——————————
Processed by CMSApril 28, 2025July 19, 2024July 21, 2023January 19, 2022February 3, 2021January 16, 2020January 24, 2019January 30, 2018January 17, 2017January 20, 2016February 11, 2015January 27, 2014January 28, 2013
Total patient revenue$23,370,489$18,109,022$17,557,086$37,687,054$34,563,997$29,565,823$32,644,951$31,581,528$27,400,819$25,807,759$31,397,941$13,937,356$22,583,855
Contractual allowances and discounts$1,857,172$2,045,561$2,412,812$5,444,001$4,686,127$5,037,305$5,197,467$5,020,705$5,707,408$5,688,787$5,453,793$5,486,394$3,002,161
Net patient revenue$21,513,317$16,063,461$15,144,274$32,243,053$29,877,870$24,528,518$27,447,484$26,560,823$21,693,411$20,118,972$25,944,148$8,450,962$19,581,694
Total operating expenses$24,167,446$19,614,224$24,344,514$40,707,883$40,153,457$38,224,688$37,133,076$35,529,599$33,841,724$32,340,861$31,571,724$32,196,650$30,263,435
Net income from service to patients−$2,654,129−$3,550,763−$9,200,240−$8,464,830−$10,275,587−$13,696,170−$9,685,592−$8,968,776−$12,148,313−$12,221,889−$5,627,576−$23,745,688−$10,681,741
Total other income$1,424,533$1,730,576$11,657,146$10,710,927$9,649,660$14,715,674$9,873,785$13,172,978$13,609,730$13,707,043$3,721,565$22,719,661$8,841,957
Net income after other income−$1,229,596−$1,820,187$2,456,906$2,246,097−$625,927$1,019,504$188,193$4,204,202$1,461,417$1,485,154−$1,906,011−$1,026,027−$1,839,784
Net income−$1,229,596−$1,820,188$2,456,906$2,246,097−$625,927$1,019,504$188,193$4,204,202$1,461,417$1,485,154−$1,906,011−$1,026,027−$1,839,784
Total facility beds, all components132132106448106106106106106106106106106
Bed days available, all components48,312————————————
Medicare (Title XVIII) patient days4,294————————————
Other-payer patient days31,478————————————
Total patient days, all components35,77231,50813,637182,48051,91235,83137,05136,11136,46535,42929,39936,17935,612
Medicare discharges148————————————
Other-payer discharges121————————————
Total discharges, all components26997134158200226171253213247202211247
Average length of stay, Medicare, in days29.0139.0446.8528.8927.3527.8825.2128.2936.7935.1428.9537.0225.94
Average length of stay, all patients, in days132.98324.82101.771,154.94259.56158.54216.67142.73171.2143.44145.54171.46144.18

Net income, fiscal years 2024, 2023, 2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012. Checked against the form’s own arithmetic: what that check shows.

Cost reports on form CMS-2540-96, fiscal years 1996 to 2011
Form CMS-2540-962011 · report 4220822010 · report 3985702009 · report 3633682008 · report 3518662007 · report 3259562006 · report 2771052005 · report 2435622004 · report 2356422003 · report 1991602002 · report 1436542001 · report 1337532000 · report 1150271999 · report 159351998 · report 159321997 · report 159311996 · report 15929
Period beganJuly 1, 2010July 1, 2009July 1, 2008July 1, 2007July 1, 2006July 1, 2005July 1, 2004July 1, 2003July 1, 2002July 1, 2001July 1, 2000July 1, 1999July 1, 1998July 1, 1997July 1, 1996July 1, 1995
Period endedJune 30, 2011June 30, 2010June 30, 2009June 30, 2008June 30, 2007June 30, 2006June 30, 2005June 30, 2004June 30, 2003June 30, 2002June 30, 2001June 30, 2000June 30, 1999June 30, 1998June 30, 1997June 30, 1996
Report statussettledsettledsettledsettledsettledsettledsettledsettledsettledsettledsettledsettledsettledreopenedsettledsettled
Processed by CMSDecember 19, 2011May 3, 2011February 1, 2010July 22, 2009September 18, 2008May 1, 2007February 24, 2006October 27, 2005November 8, 2004May 7, 2003March 18, 2003February 11, 2003March 15, 2001April 19, 2001July 8, 1999November 6, 1998
Net patient revenue$11,265,357$10,797,916$10,257,695$9,753,572$9,336,764$8,331,997————$5,838,218$3,266,741$3,286,000$5,402,233$4,956,932$4,859,413
Total operating expenses$11,828,323$11,188,405$11,407,924$10,236,918$9,450,107$9,032,586————$6,853,354$6,165,084$5,741,019$5,594,540$4,771,886$4,718,357
Net income from service to patients−$562,966−$390,489−$1,150,229−$483,346−$113,343−$700,589————−$1,015,136−$2,898,343−$2,455,019−$192,307$185,046$141,056
Total other income$465,042$468,314$716,041$1,341,910$205,847$780,804————$1,015,137$2,898,647$2,532,894$153,923$162,574$245,590
Total other expenses———————————————$17
Net income−$97,924$77,825−$434,188$858,564$92,504$80,215————$1$304$77,875−$38,384$347,620$386,629
Total facility beds, all components106106106106106106————8282400828282
Total patient days, all components37,12235,31535,36833,75132,79630,520————26,69827,01624,73328,05527,57528,321
Total discharges, all components227289227258237194————173120142193220226
Average length of stay, Medicare, in days29.7732.0835.532.2834.3140.89————40.7551.6837.9439.6618.5621.03
Average length of stay, all patients, in days163.53122.2155.81130.82138.38157.32————154.32225.13174.18145.36125.34125.31

Net income, fiscal years 2011, 2010, 2009, 2008, 2007, 2006, 2001, 2000, 1999, 1998, 1997, 1996. Checked against the form’s own arithmetic: what that check shows.

None of these figures is carried on the report for fiscal years 2005, 2004, 2003, 2002.

HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO: nurse staffing hours by quarter →

Who owns HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO, as filed with CMS

Care Compare

  • 5% OR GREATER DIRECT OWNERSHIP INTEREST: RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION (organization), 100%%, since 07/02/1999
  • ADP OF THE SNF: JO, DANIEL (individual), NOT APPLICABLE, since 04/22/2025; LIFE CARE SERVICES LLC (organization), NOT APPLICABLE, since 04/22/2025; NELSON, MARK (individual), NOT APPLICABLE, since 04/22/2025; RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION (organization), NOT APPLICABLE, since 05/31/1992
  • CORPORATE DIRECTOR: EXLINE, RICK (individual), NOT APPLICABLE, since 01/01/2025; JOHNSON, EIKO (individual), NOT APPLICABLE, since 01/01/2023
  • CORPORATE OFFICER: BRAUMAN, SHARON (individual), NOT APPLICABLE, since 01/01/2020; BROWN, KATHY (individual), NOT APPLICABLE, since 01/01/2024; BUSH, ELLYN (individual), NOT APPLICABLE, since 01/01/2023; FISHBEIN, MARGERY (individual), NOT APPLICABLE, since 01/01/2024
  • OPERATIONAL/MANAGERIAL CONTROL: JO, DANIEL (individual), NOT APPLICABLE, since 02/01/2025; KAO, NANCY (individual), NOT APPLICABLE, since 05/01/2000; LIFE CARE SERVICES LLC (organization), NOT APPLICABLE, since 06/01/2012; NELSON, MARK (individual), NOT APPLICABLE, since 11/04/2024

Medicare enrollment

As filed in the CMS file dated October 1, 2026 (Medicare enrollment ownership), under the enrollment of RANCHO SAN ANTONIO RETIREMENT SERVICES, INC. (enrollment ID O20111114000671).

  • 5% OR GREATER DIRECT OWNERSHIP INTEREST: RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION (organization), 100.00%, since 07/02/1999
  • ADP OF THE SNF: DANIEL H JO (individual), since 04/22/2025; LIFE CARE SERVICES LLC (organization), since 04/22/2025; MARK NELSON (individual), since 04/22/2025; RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION (organization), since 05/31/1992
  • CORPORATE DIRECTOR: EIKO JOHNSON (individual), 0.00%, since 01/01/2023; RICK EXLINE (individual), 0.00%, since 01/01/2025
  • CORPORATE OFFICER: ELLYN BUSH (individual), 0.00%, since 01/01/2023; KATHY BROWN (individual), 0.00%, since 01/01/2024; MARGERY FISHBEIN (individual), 0.00%, since 01/01/2024; SHARON BRAUMAN (individual), 0.00%, since 01/01/2020
  • OPERATIONAL/MANAGERIAL CONTROL: DANIEL H JO (individual), since 02/01/2025; LIFE CARE SERVICES LLC (organization), 0.00%, since 06/01/2012; MARK NELSON (individual), since 11/04/2024; NANCY H. KAO (individual), 0.00%, since 05/01/2000

Paused by CMS: Form CMS-855A, December 11, 2025.

Private equity company, real estate investment trust and holding company: No: RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION; LIFE CARE SERVICES LLC; RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION; LIFE CARE SERVICES LLC.

Private equity company, real estate investment trust and holding company: Paused by CMS: DANIEL H JO; MARK NELSON; EIKO JOHNSON; RICK EXLINE; ELLYN BUSH; KATHY BROWN; MARGERY FISHBEIN; SHARON BRAUMAN; DANIEL H JO; MARK NELSON; NANCY H. KAO.

Changes in ownership

  • July 1, 2025, enrollment ownership file; no longer listed: RANCHO SAN ANTONIO RETIREMENT SERVICES, INC. (OPERATIONAL/MANAGERIAL CONTROL); BRIAN WEAVER (OPERATIONAL/MANAGERIAL CONTROL); LILY YOUNG (CORPORATE DIRECTOR); LILY YOUNG (CORPORATE OFFICER); first listed: DANIEL H JO (ADP OF THE SNF), associated since April 22, 2025; DANIEL H JO (OPERATIONAL/MANAGERIAL CONTROL), associated since February 1, 2025; MARK NELSON (ADP OF THE SNF), associated since April 22, 2025; MARK NELSON (OPERATIONAL/MANAGERIAL CONTROL), associated since November 4, 2024; EIKO JOHNSON (CORPORATE DIRECTOR), associated since January 1, 2023; MARGERY FISHBEIN (CORPORATE OFFICER), associated since January 1, 2024; LIFE CARE SERVICES LLC (ADP OF THE SNF), associated since April 22, 2025; RICK EXLINE (CORPORATE DIRECTOR), associated since January 1, 2025; RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION (ADP OF THE SNF), associated since May 31, 1992. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
  • June 1, 2025, enrollment ownership file; no longer listed: PHILIP SUNSHINE (CORPORATE OFFICER). Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
  • April 1, 2025, enrollment ownership file; no longer listed: MILDRED G VASAN (CORPORATE DIRECTOR); MILDRED G VASAN (CORPORATE OFFICER). Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
  • April 14, 2023, enrollment ownership file; no longer listed: LOIS ADAMS (DIRECTOR); LOIS ADAMS (OFFICER); MEHRDAD AYATI (DIRECTOR); JEROME FISCHBEIN (DIRECTOR); EDITH H TOUSEY (DIRECTOR); VERNON K CLIFFORD (DIRECTOR); VERNON K CLIFFORD (OFFICER); first listed: SHARON BRAUMAN (OFFICER), associated since January 1, 2020; ELLYN BUSH (OFFICER), associated since January 1, 2023; KATHY BROWN (OFFICER), associated since January 1, 2021; PHILIP SUNSHINE (OFFICER), associated since January 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv

Inspections of HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO

  • Cycle 1: health January 30, 2026 (17 deficiencies), fire safety January 30, 2026 (6)
  • Cycle 2: health July 19, 2024 (13 deficiencies), fire safety July 19, 2024 (3)
  • Cycle 3: health June 9, 2023 (6 deficiencies), fire safety June 9, 2023 (3)

Deficiencies cited at HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO

36 deficiencies on file, by tag, newest citation first

every one from a health inspection; every one marked “Deficient, Provider has date of correction”; 3 cited from a complaint, marked below. Letter after a date: scope and severity grade.

  • F 0551, resident rights: May 14, 2026 (D, from a complaint, corrected May 26, 2026).
  • F 0550, resident rights: April 9, 2026 (D, from a complaint, corrected April 17, 2026); January 30, 2026 (D, corrected February 28, 2026); July 19, 2024 (D, corrected August 18, 2024).
  • F 0578, resident rights: January 30, 2026 (E, corrected February 28, 2026); July 19, 2024 (E, corrected August 18, 2024).
  • F 0605, freedom from abuse, neglect, and exploitation: January 30, 2026 (E, corrected February 28, 2026).
  • F 0656, resident assessment and care planning: January 30, 2026 (E, corrected February 28, 2026); July 19, 2024 (D, corrected August 18, 2024).
  • F 0657, resident assessment and care planning: January 30, 2026 (D, corrected February 28, 2026).
  • F 0684, quality of life and care: January 30, 2026 (D, corrected February 28, 2026); September 6, 2024 (D, from a complaint, corrected September 20, 2024).
  • F 0689, quality of life and care: January 30, 2026 (D, corrected February 28, 2026).
  • F 0697, quality of life and care: January 30, 2026 (E, corrected February 28, 2026).
  • F 0700, quality of life and care: January 30, 2026 (D, corrected February 28, 2026); July 19, 2024 (D, corrected August 18, 2024).
  • F 0755, pharmacy service: January 30, 2026 (E, corrected February 28, 2026).
  • F 0756, pharmacy service: January 30, 2026 (E, corrected February 28, 2026).
  • F 0757, pharmacy service: January 30, 2026 (E, corrected February 28, 2026).
  • F 0804, nutrition and dietary: January 30, 2026 (E, corrected February 28, 2026).
  • F 0812, nutrition and dietary: January 30, 2026 (F, corrected February 28, 2026); July 19, 2024 (E, corrected August 18, 2024); June 9, 2023 (E, corrected July 9, 2023).
  • F 0880, infection control: January 30, 2026 (E, corrected February 28, 2026); July 19, 2024 (E, corrected August 18, 2024); June 9, 2023 (E, corrected July 9, 2023).
  • F 0582, resident rights: July 19, 2024 (D, corrected August 18, 2024).
  • F 0641, resident assessment and care planning: July 19, 2024 (D, corrected August 18, 2024).
  • F 0658, resident assessment and care planning: July 19, 2024 (D, corrected August 18, 2024); June 9, 2023 (D, corrected July 9, 2023).
  • F 0695, quality of life and care: July 19, 2024 (D, corrected August 18, 2024).
  • F 0732, nursing and physician services: July 19, 2024 (D, corrected August 18, 2024).
  • F 0758, pharmacy service: July 19, 2024 (D, corrected August 18, 2024); June 9, 2023 (D, corrected July 9, 2023).
  • F 0761, pharmacy service: July 19, 2024 (E, corrected August 18, 2024); June 9, 2023 (E, corrected July 9, 2023).

HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO in Care Compare

  • Ownership Type: Non profit - Other
  • Legal Business Name: RANCHO SAN ANTONIO RETIREMENT SERVICES, INC.
  • Date First Approved to Provide Medicare and Medicaid Services: 1992-09-01
  • Provider Resides in Hospital: N
  • Continuing Care Retirement Community: Y
  • Urban: Y
  • County/Parish: Santa Clara
  • Telephone Number: 6509440200
  • Chain Name: LIFE CARE SERVICES
  • Chain ID: 312
  • Provider Changed Ownership in Last 12 Months: N
  • With a Resident and Family Council: Both
  • Automatic Sprinkler Systems in All Required Areas: Yes
  • Average Number of Residents per Day: 48.2
  • Overall Rating: 3
  • Health Inspection Rating: 2
  • QM Rating: 4
  • Long-Stay QM Rating: 4
  • Short-Stay QM Rating: 4

Care Compare, October 1, 2026: provider information NH_ProviderInfo_Oct2026.csv · inspections NH_SurveySummary_Oct2026.csv · citations NH_HealthCitations_Oct2026.csv · ownership NH_Ownership_Oct2026.csv.

Nothing on file for HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO: no penalty in Care Compare.

Other nursing facilities in CUPERTINO and California

Report a figure on HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO’s record that differs from its CMS file, quoting 555524.