Cornerstone Care Option - Portland Nursing Home
General Information
UPDATEFederal Provider Number
380000000000000000000000000000
Provider Name
CORNERSTONE CARE OPTION
Provider Address
12640 SE BUSH
PORTLAND, OR 97236
PORTLAND, OR 97236
Provider Phone Number
(503) 761-6621
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
39
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-04-01
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
3.14615
Reported LPN Staffing Hours per Resident per Day
0.23462
Reported RN Staffing Hours per Resident per Day
1.05385
Reported Licensed Staffing Hours per Resident per Day
1.28846
Reported Total Nurse Staffing Hours per Resident per Day
4.43462
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00128
Expected CNA Staffing Hours per Resident per Day
2.68472
Expected LPN Staffing Hours per Resident per Day
0.57481
Expected RN Staffing Hours per Resident per Day
0.79663
Expected Total Nurse Staffing Hours per Resident per Day
4.05616
Adjusted CNA Staffing Hours per Resident per Day
2.87543
Adjusted LPN Staffing Hours per Resident per Day
0.33878
Adjusted RN Staffing Hours per Resident per Day
0.98846
Adjusted Total Nurse Staffing Hours per Resident per Day
4.40700
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-08-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-02-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-01-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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