Maryville Nursing Home - Beaverton Nursing Home
General Information
UPDATEFederal Provider Number
385166
Provider Name
MARYVILLE NURSING HOME
Provider Address
14645 SW FARMINGTON ROAD
BEAVERTON, OR 97007
BEAVERTON, OR 97007
Provider Phone Number
(503) 643-8626
Provider SSA County
330
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
155
Number of Residents in Certified Beds
138
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SISTERS OF ST. MARY OF OREGON - MARYVILLE CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1985-02-22
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
3.27174
Reported LPN Staffing Hours per Resident per Day
0.46014
Reported RN Staffing Hours per Resident per Day
0.91920
Reported Licensed Staffing Hours per Resident per Day
1.37935
Reported Total Nurse Staffing Hours per Resident per Day
4.65108
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16558
Expected CNA Staffing Hours per Resident per Day
2.62702
Expected LPN Staffing Hours per Resident per Day
0.66491
Expected RN Staffing Hours per Resident per Day
1.06568
Expected Total Nurse Staffing Hours per Resident per Day
4.35761
Adjusted CNA Staffing Hours per Resident per Day
3.05588
Adjusted LPN Staffing Hours per Resident per Day
0.57439
Adjusted RN Staffing Hours per Resident per Day
0.64450
Adjusted Total Nurse Staffing Hours per Resident per Day
4.30237
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
40
Cycle 1 Standard Survey Health Date
2014-03-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
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
28
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2011-04-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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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