Holladay Park Plaza - Portland Nursing Home
General Information
UPDATEFederal Provider Number
385259
Provider Name
HOLLADAY PARK PLAZA
Provider Address
1300 NE 16TH AVENUE
PORTLAND, OR 97232
PORTLAND, OR 97232
Provider Phone Number
(503) 288-6671
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
44
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
HOLLADAY PARK PLAZA INC
Date First Approved to Provide Medicare and Medicaid services
1998-08-14
Continuing Care Retirement Community
Y
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
3
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
3.67273
Reported LPN Staffing Hours per Resident per Day
0.51705
Reported RN Staffing Hours per Resident per Day
0.85682
Reported Licensed Staffing Hours per Resident per Day
1.37386
Reported Total Nurse Staffing Hours per Resident per Day
5.04660
Reported Physical Therapist Staffing Hours per Resident Per Day
0.28409
Expected CNA Staffing Hours per Resident per Day
2.46290
Expected LPN Staffing Hours per Resident per Day
0.67953
Expected RN Staffing Hours per Resident per Day
1.22155
Expected Total Nurse Staffing Hours per Resident per Day
4.36398
Adjusted CNA Staffing Hours per Resident per Day
3.65901
Adjusted LPN Staffing Hours per Resident per Day
0.63154
Adjusted RN Staffing Hours per Resident per Day
0.52410
Adjusted Total Nurse Staffing Hours per Resident per Day
4.66142
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-08-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
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
20
Cycle 3 Standard Health Survey Date
2012-04-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
28.00000
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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