Avamere Crestview Of Portland - Portland Nursing Home
General Information
UPDATEFederal Provider Number
385031
Provider Name
AVAMERE CRESTVIEW OF PORTLAND
Provider Address
6530 SW 30TH AVENUE
PORTLAND, OR 97239
PORTLAND, OR 97239
Provider Phone Number
(503) 244-7533
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CRESTVIEW OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.41364
Reported LPN Staffing Hours per Resident per Day
0.98896
Reported RN Staffing Hours per Resident per Day
1.16429
Reported Licensed Staffing Hours per Resident per Day
2.15325
Reported Total Nurse Staffing Hours per Resident per Day
5.56689
Reported Physical Therapist Staffing Hours per Resident Per Day
0.32857
Expected CNA Staffing Hours per Resident per Day
2.66682
Expected LPN Staffing Hours per Resident per Day
0.74625
Expected RN Staffing Hours per Resident per Day
1.20311
Expected Total Nurse Staffing Hours per Resident per Day
4.61617
Adjusted CNA Staffing Hours per Resident per Day
3.14084
Adjusted LPN Staffing Hours per Resident per Day
1.09995
Adjusted RN Staffing Hours per Resident per Day
0.72309
Adjusted Total Nurse Staffing Hours per Resident per Day
4.86108
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-06-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2012-11-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2011-07-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
56.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
Number of Fines
2
Total Amount of Fines in Dollars
9620
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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