Pacific Health And Rehabilitation - Tigard Nursing Home
General Information
UPDATEFederal Provider Number
385272
Provider Name
PACIFIC HEALTH AND REHABILITATION
Provider Address
14145 SW 105TH STREET
TIGARD, OR 97224
TIGARD, OR 97224
Provider Phone Number
(503) 639-1144
Provider SSA County
330
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PACIFIC GARDENS ESTATES LLC
Date First Approved to Provide Medicare and Medicaid services
2006-04-01
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
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.55368
Reported LPN Staffing Hours per Resident per Day
0.55882
Reported RN Staffing Hours per Resident per Day
0.56397
Reported Licensed Staffing Hours per Resident per Day
1.12279
Reported Total Nurse Staffing Hours per Resident per Day
4.67647
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05809
Expected CNA Staffing Hours per Resident per Day
2.27553
Expected LPN Staffing Hours per Resident per Day
0.74373
Expected RN Staffing Hours per Resident per Day
1.24997
Expected Total Nurse Staffing Hours per Resident per Day
4.26923
Adjusted CNA Staffing Hours per Resident per Day
3.83192
Adjusted LPN Staffing Hours per Resident per Day
0.62364
Adjusted RN Staffing Hours per Resident per Day
0.33713
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41541
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-06-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
7735
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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