Tierra Rose Care Center - Salem Nursing Home
General Information
UPDATEFederal Provider Number
380000000000000000000000000000
Provider Name
TIERRA ROSE CARE CENTER
Provider Address
4254 WEATHERS STREET NE
SALEM, OR 97301
SALEM, OR 97301
Provider Phone Number
(503) 585-4602
Provider SSA County
230
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
76
Number of Residents in Certified Beds
66
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1980-04-01
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
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.97955
Reported LPN Staffing Hours per Resident per Day
0.42348
Reported RN Staffing Hours per Resident per Day
0.45000
Reported Licensed Staffing Hours per Resident per Day
0.87348
Reported Total Nurse Staffing Hours per Resident per Day
4.85303
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.47449
Expected LPN Staffing Hours per Resident per Day
0.55791
Expected RN Staffing Hours per Resident per Day
0.74326
Expected Total Nurse Staffing Hours per Resident per Day
3.77566
Adjusted CNA Staffing Hours per Resident per Day
3.94612
Adjusted LPN Staffing Hours per Resident per Day
0.63001
Adjusted RN Staffing Hours per Resident per Day
0.45239
Adjusted Total Nurse Staffing Hours per Resident per Day
5.18111
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
103
Cycle 1 Standard Survey Health Date
2014-07-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
103
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-03-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2011-12-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
91.50000
Number of Facility Reported Incidents
0
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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