Windsor Health & Rehabilitation Center - Salem Nursing Home
General Information
UPDATEFederal Provider Number
385224
Provider Name
WINDSOR HEALTH & REHABILITATION CENTER
Provider Address
820 COTTAGE STREET NE
SALEM, OR 97301
SALEM, OR 97301
Provider Phone Number
5033991135
Provider SSA County
230
Provider County Name
Marion
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN OREGON HEALTHCARE SALEM, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1991-07-03
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
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
2.73500
Reported LPN Staffing Hours per Resident per Day
0.82700
Reported RN Staffing Hours per Resident per Day
0.99200
Reported Licensed Staffing Hours per Resident per Day
1.81900
Reported Total Nurse Staffing Hours per Resident per Day
4.55400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.23600
Expected CNA Staffing Hours per Resident per Day
2.50264
Expected LPN Staffing Hours per Resident per Day
0.83701
Expected RN Staffing Hours per Resident per Day
1.42196
Expected Total Nurse Staffing Hours per Resident per Day
4.76161
Adjusted CNA Staffing Hours per Resident per Day
2.68152
Adjusted LPN Staffing Hours per Resident per Day
0.82007
Adjusted RN Staffing Hours per Resident per Day
0.52127
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85515
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
12
Cycle 1 Standard Survey Health Date
2014-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2012-08-13
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
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2011-08-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
1625
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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