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Corvallis Manor - Corvallis Nursing Home

General Information

UPDATE
Federal Provider Number
385072
Provider Name
CORVALLIS MANOR
Provider Address
160 NE CONIFER BLVD
CORVALLIS, OR 97330
Provider Phone Number
5417571651
Provider SSA County
10
Provider County Name
Benton
Ownership Type
For profit - Corporation
Number of Certified Beds
135
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MCH ENTERPRISES, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-05-01
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
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.98542
Reported LPN Staffing Hours per Resident per Day
0.47500
Reported RN Staffing Hours per Resident per Day
1.01458
Reported Licensed Staffing Hours per Resident per Day
1.48958
Reported Total Nurse Staffing Hours per Resident per Day
4.47500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22222
Expected CNA Staffing Hours per Resident per Day
2.55212
Expected LPN Staffing Hours per Resident per Day
0.74899
Expected RN Staffing Hours per Resident per Day
1.40226
Expected Total Nurse Staffing Hours per Resident per Day
4.70337
Adjusted CNA Staffing Hours per Resident per Day
2.87029
Adjusted LPN Staffing Hours per Resident per Day
0.52638
Adjusted RN Staffing Hours per Resident per Day
0.54062
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83518
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-11-22
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
42
Cycle 2 Total Health Score
42
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
47.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
1625
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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