Glisan Care Center - Portland Nursing Home
General Information
UPDATEFederal Provider Number
385136
Provider Name
GLISAN CARE CENTER
Provider Address
9750 NE GLISAN STREET
PORTLAND, OR 97220
PORTLAND, OR 97220
Provider Phone Number
(503) 256-3920
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE CENTER (GLISAN), INC.
Date First Approved to Provide Medicare and Medicaid services
1977-02-15
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
2.58952
Reported LPN Staffing Hours per Resident per Day
0.51290
Reported RN Staffing Hours per Resident per Day
1.09435
Reported Licensed Staffing Hours per Resident per Day
1.60726
Reported Total Nurse Staffing Hours per Resident per Day
4.19677
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08629
Expected CNA Staffing Hours per Resident per Day
2.40523
Expected LPN Staffing Hours per Resident per Day
0.62968
Expected RN Staffing Hours per Resident per Day
1.12959
Expected Total Nurse Staffing Hours per Resident per Day
4.16450
Adjusted CNA Staffing Hours per Resident per Day
2.64170
Adjusted LPN Staffing Hours per Resident per Day
0.67607
Adjusted RN Staffing Hours per Resident per Day
0.72389
Adjusted Total Nurse Staffing Hours per Resident per Day
4.06214
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
169
Cycle 1 Standard Survey Health Date
2014-03-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
169
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2012-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2011-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
107.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
4550
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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