Village Health Care - Gresham Nursing Home

General Information

UPDATE
Federal Provider Number
385068
Provider Name
VILLAGE HEALTH CARE
Provider Address
3955 SE 182ND AVENUE
GRESHAM, OR 97030
Provider Phone Number
5036650183
Provider SSA County
250
Provider County Name
Multnomah
Ownership Type
For profit - Partnership
Number of Certified Beds
106
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VILLAGE HEALTH CARE I, LLC
Date First Approved to Provide Medicare and Medicaid services
1967-04-03
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
4
Health Inspection Rating Footnote
QM Rating
4
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
3.39247
Reported LPN Staffing Hours per Resident per Day
0.36096
Reported RN Staffing Hours per Resident per Day
0.87740
Reported Licensed Staffing Hours per Resident per Day
1.23836
Reported Total Nurse Staffing Hours per Resident per Day
4.63083
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17123
Expected CNA Staffing Hours per Resident per Day
2.64966
Expected LPN Staffing Hours per Resident per Day
0.68496
Expected RN Staffing Hours per Resident per Day
1.14135
Expected Total Nurse Staffing Hours per Resident per Day
4.47597
Adjusted CNA Staffing Hours per Resident per Day
3.14158
Adjusted LPN Staffing Hours per Resident per Day
0.43739
Adjusted RN Staffing Hours per Resident per Day
0.57440
Adjusted Total Nurse Staffing Hours per Resident per Day
4.17036
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-07-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
20
Cycle 2 Standard Health Survey Date
2012-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
36
Cycle 3 Standard Health Survey Date
2011-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
1600
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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