12 health deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
4 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Portland, OR
3-star overall rating with 2-star inspections with $96,299 in total fines with 11 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
6125 Sw Boundary Street, Portland, OR
(503) 535-4300
Overall
3 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Beds
92
Certified beds
Average residents
76
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1979-11-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
RN hours / resident day
0.80
Registered nurse staffing · state 0.68 · national 0.68
LPN hours / resident day
0.72
Licensed practical nurse staffing · state 0.91 · national 0.87
Aide hours / resident day
3.57
Nurse aide staffing · state 3.37 · national 2.35
Total nurse hours
5.10
All reported nurse hours · state 4.95 · national 3.89
Licensed hours
1.53
RN + LPN hours · state 1.58 · national 1.54
Weekend hours
4.58
Weekend nurse staffing · state 4.39 · national 3.43
Weekend RN hours
0.43
Weekend registered nurse coverage · state 0.44 · national 0.47
Physical therapist
0.15
Reported PT staffing · state 0.09 · national 0.07
Adjusted RN hours
0.80
CMS adjusted RN staffing hours
Adjusted total hours
5.08
CMS adjusted total nurse staffing hours
Case-mix index
1.37
Higher values indicate more complex resident acuity
RN turnover
38%
Annual RN turnover · state 53% · national 45%
Total nurse turnover
28%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Program rank
30
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
95.81
Composite VBP score used to determine payment impact.
Payment multiplier
1.0276
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
10
Baseline 51.19% · Performance 20.00% · Measure score 10 · Achievement 10 · Improvement 9
Adjusted total nurse staffing
9.16
Baseline 4.07 hours · Performance 5.68 hours · Measure score 9.16 · Achievement 9.16 · Improvement 8.94
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.28% |
10.72%
0.4 pts better
|
No Different than the National Rate · Eligible stays 79 · Observed rate 7.59% · Lower 95% interval 7.1% |
| Discharge to community | 65.84% |
50.57%
15.3 pts better
|
Better than the National Rate · Eligible stays 75 · Observed rate 64% · Lower 95% interval 55.31% |
| Medicare spending per beneficiary | 0.71 |
1.02
0.3 pts better
|
|
| Drug regimen review with follow-up | 95.92% |
95.27%
0.7 pts better
|
Numerator 47 · Denominator 49 |
| Falls with major injury | 6.12% |
0.77%
5.3 pts worse
|
Numerator 3 · Denominator 49 |
| Discharge self-care score | 75.76% |
53.69%
22.1 pts better
|
Numerator 25 · Denominator 33 |
| Discharge mobility score | 39.39% |
50.94%
11.5 pts worse
|
Numerator 13 · Denominator 33 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 49 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 22 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 18.02% |
8.2%
9.8 pts better
|
Numerator 20 · Denominator 111 |
| Staff flu vaccination coverage | Not Available |
42%
|
Numerator Not Available · Denominator Not Available · No data were submitted for this measure. |
| Discharge function score | 57.58% |
56.45%
1.1 pts better
|
Numerator 19 · Denominator 33 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 7 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 97.44% |
96.28%
1.2 pts better
|
Numerator 38 · Denominator 39 |
| Resident COVID-19 vaccinations up to date | 50% |
25.2%
24.8 pts better
|
Numerator 20 · Denominator 40 |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 97.9% |
95.5%
2.4 pts better
|
93.4%
4.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 97.1% · Q2 97.1% · Q3 97.1% · Q4 100.0% · 4Q avg 97.9% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
95.2%
4.8 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.8% |
2.4%
0.4 pts worse
|
3.3%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.9% · Q2 2.9% · Q3 2.9% · Q4 2.6% · 4Q avg 2.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 3.1% |
4.7%
1.6 pts better
|
11.4%
8.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 6.2% · Q3 3.4% · Q4 0.0% · 4Q avg 3.1% |
| Percentage of long-stay residents who lose too much weight | 7.0% |
5.0%
2 pts worse
|
5.4%
1.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.1% · Q3 13.3% · Q4 11.4% · 4Q avg 7.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 11.3% |
12.5%
1.2 pts better
|
19.6%
8.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 3.0% · Q3 16.1% · Q4 21.6% · 4Q avg 11.3% |
| Percentage of long-stay residents who received an antipsychotic medication | 10.4% |
14.7%
4.3 pts better
|
16.7%
6.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.9% · Q2 10.0% · Q3 10.0% · Q4 13.9% · 4Q avg 10.4% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 25.4% |
24.1%
1.3 pts worse
|
16.3%
9.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 25.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 22.0% |
15.8%
6.2 pts worse
|
14.9%
7.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.1% · Q2 23.3% · Q3 25.0% · Q4 23.5% · 4Q avg 22.0% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.5% |
1.7%
1.2 pts better
|
1.0%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.2% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.7% |
2.0%
1.3 pts better
|
1.7%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.9% · Q3 0.0% · Q4 0.0% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 31.4% |
22.2%
9.2 pts worse
|
19.8%
11.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 45.3% · Q2 29.7% · Q3 29.6% · Q4 21.1% · 4Q avg 31.4% |
| Percentage of long-stay residents with pressure ulcers | 5.6% |
6.5%
0.9 pts better
|
5.1%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.4% · Q2 6.1% · Q3 7.0% · Q4 6.0% · 4Q avg 5.6% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 95.1% |
85.4%
9.7 pts better
|
81.7%
13.4 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 99.4% · Q3 97.5% · Q4 89.2% · 4Q avg 95.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 15.3% |
15.1%
0.2 pts worse
|
12.0%
3.3 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 15.3% · Observed 14.9% · Expected 10.9% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.7%
1.7 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 98.2% |
81.2%
17 pts better
|
79.7%
18.5 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 98.2% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 17.4% |
21.6%
4.2 pts better
|
23.9%
6.5 pts better
|
Short Stay · 20240701-20250630 · Adjusted 17.4% · Observed 16.4% · Expected 22.5% · Used in QM five-star |
Survey summary
Top issue: Quality of Life and Care (6 deficiencies)
4 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Top issue: Nursing and Physician Services (2 deficiencies)
4 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Top issue: Quality of Life and Care (5 deficiencies)
13 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (4 deficiencies)
Fire safety
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-08-29
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-08-29
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2024-08-29
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2024-08-29
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-06-10
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-06-10
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2023-06-10
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2023-06-10
Fire Safety
Install noncombustible or limited-combustible interior walls.
Corrected 2022-05-03
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2022-05-03
Fire Safety
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Corrected 2022-05-03
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2022-05-03
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2022-05-03
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2022-05-03
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2022-05-03
Fire Safety
Have power receptacles that are properly grounded.
Corrected 2022-05-03
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2022-05-03
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2022-05-03
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2022-05-03
Fire Safety
Have restrictions on the use of highly flammable decorations.
Corrected 2022-05-03
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2022-05-03
Inspection history
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2025-12-02
Health
Provide and implement an infection prevention and control program.
Corrected 2025-10-30
Health
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Corrected 2025-10-30
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-10-30
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2025-10-30
Health
Provide or get specialized rehabilitative services as required for a resident.
Corrected 2025-10-30
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2025-10-30
Health
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected 2025-10-30
Health
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected 2025-10-30
Health
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Corrected 2025-10-30
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2025-10-16
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-10-16
Health
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Corrected 2025-03-27
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-08-29
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2024-08-29
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-08-29
Health
Provide and implement an infection prevention and control program.
Corrected 2024-08-29
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2024-08-29
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-08-29
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-08-29
Health
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Corrected 2024-08-29
Health
Ensure that residents are free from significant medication errors.
Corrected 2024-08-29
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-06-10
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-06-10
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2023-06-10
Health
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Corrected 2023-06-10
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-06-10
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-06-10
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2023-06-10
Health
Provide enough food/fluids to maintain a resident's health.
Corrected 2023-06-10
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2023-06-10
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2023-06-10
Penalties and ownership
Fine · fine $57,970
Fine
Fine · fine $10,839
Fine
Fine · fine $3,496
Fine
Fine · fine $3,147
Fine
Fine · fine $2,797
Fine
Fine · fine $2,447
Fine
Fine · fine $2,098
Fine
Fine · fine $4,194
Fine
Fine · fine $9,311
Fine
5% Or Greater Direct Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Individual
Operational/Managerial Control · Individual
Operational/Managerial Control · Individual
Corporate Officer · Individual
Operational/Managerial Control · Individual
Nearby options
Portland, OR
4-star overall rating with 2-star inspections with abuse icon flag with 6 recent health deficiencies with 9 fire-safety deficiencies in the latest cycle
Portland, OR
5-star overall rating with 4-star inspections with 4 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
Portland, OR
3-star overall rating with 3-star inspections with $12,659 in total fines with 3 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
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