Gracelen Terrace Nf - Portland Nursing Home
General Information
UPDATEFederal Provider Number
380000000000000000000000000000
Provider Name
GRACELEN TERRACE NF
Provider Address
10948 S.E. BOISE
PORTLAND, OR 97266
PORTLAND, OR 97266
Provider Phone Number
(503) 760-1727
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
80
Number of Residents in Certified Beds
79
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
1976-12-06
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
3.44177
Reported LPN Staffing Hours per Resident per Day
0.51076
Reported RN Staffing Hours per Resident per Day
0.52785
Reported Licensed Staffing Hours per Resident per Day
1.03861
Reported Total Nurse Staffing Hours per Resident per Day
4.48038
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.40600
Expected LPN Staffing Hours per Resident per Day
0.52821
Expected RN Staffing Hours per Resident per Day
0.71319
Expected Total Nurse Staffing Hours per Resident per Day
3.64740
Adjusted CNA Staffing Hours per Resident per Day
3.51000
Adjusted LPN Staffing Hours per Resident per Day
0.80259
Adjusted RN Staffing Hours per Resident per Day
0.55302
Adjusted Total Nurse Staffing Hours per Resident per Day
4.95147
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-02-23
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-09-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
13.33300
Number of Facility Reported Incidents
1
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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