Marquis Forest Grove Post Acute Rehab - Forest Grove Nursing Home
General Information
UPDATEFederal Provider Number
385204
Provider Name
MARQUIS FOREST GROVE POST ACUTE REHAB
Provider Address
3300 19TH AVENUE
FOREST GROVE, OR 97116
FOREST GROVE, OR 97116
Provider Phone Number
(503) 357-7119
Provider SSA County
330
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
114
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.72292
Reported LPN Staffing Hours per Resident per Day
0.45729
Reported RN Staffing Hours per Resident per Day
0.94479
Reported Licensed Staffing Hours per Resident per Day
1.40208
Reported Total Nurse Staffing Hours per Resident per Day
4.12500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10104
Expected CNA Staffing Hours per Resident per Day
2.61084
Expected LPN Staffing Hours per Resident per Day
0.65165
Expected RN Staffing Hours per Resident per Day
1.02401
Expected Total Nurse Staffing Hours per Resident per Day
4.28650
Adjusted CNA Staffing Hours per Resident per Day
2.55903
Adjusted LPN Staffing Hours per Resident per Day
0.58244
Adjusted RN Staffing Hours per Resident per Day
0.68940
Adjusted Total Nurse Staffing Hours per Resident per Day
3.87903
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
2014-08-22
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-03-15
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
14
Cycle 2 Total Health Score
42
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
124
Cycle 3 Standard Health Survey Date
2012-01-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
124
Total Weighted Health Survey Score
34.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
3
Total Amount of Fines in Dollars
4875
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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