Park Forest Care Center - Portland Nursing Home
General Information
UPDATEFederal Provider Number
385258
Provider Name
PARK FOREST CARE CENTER
Provider Address
8643 NE BEECH STREET
PORTLAND, OR 97220
PORTLAND, OR 97220
Provider Phone Number
(503) 256-2151
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
37
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE CENTER (PARK FOREST), INC.
Date First Approved to Provide Medicare and Medicaid services
1998-06-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
2.90135
Reported LPN Staffing Hours per Resident per Day
0.89189
Reported RN Staffing Hours per Resident per Day
0.72703
Reported Licensed Staffing Hours per Resident per Day
1.61892
Reported Total Nurse Staffing Hours per Resident per Day
4.52027
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07162
Expected CNA Staffing Hours per Resident per Day
2.54713
Expected LPN Staffing Hours per Resident per Day
0.70336
Expected RN Staffing Hours per Resident per Day
1.02529
Expected Total Nurse Staffing Hours per Resident per Day
4.27579
Adjusted CNA Staffing Hours per Resident per Day
2.79493
Adjusted LPN Staffing Hours per Resident per Day
1.05247
Adjusted RN Staffing Hours per Resident per Day
0.52984
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26138
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-05-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2012-10-26
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
3
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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