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Home / Oregon / Portland

Portland Health and Rehabilitation

12441 Se Stark Street, Portland, OR 97233 · Multnomah County · (503) 255-7040

105 certified beds, about 55 residents a day · For profit - Corporation · Medicare and Medicaid since 1992

Certified for Medicaid Certified for Medicare
Overall
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
4 of 5

CMS Care Compare ratings, data as of September 1, 2026 · CCN 385228 · See it on Medicare.gov · Compare with other homes

The record in brief

At its most recent standard inspection, on February 27, 2026, inspectors cited 18 health deficiencies (the Oregon average is 9.2, the national average 9.2).

Of 55 health citations since July 2023, 2 were rated as actual harm or immediate jeopardy to residents.

CMS lists 1 fine totaling $24,827 in the last three years; the largest was $24,827, and the latest is dated October 29, 2024.

Nurses and nurse aides worked 4.68 hours per resident per day, against 5.03 across Oregon and 3.86 nationally. Registered nurses accounted for 0.88 of those hours.

50.0% of nursing staff left within the year CMS measured (Oregon average 47.4%).

CMS links it to Evergreen Healthcare Group, an affiliated group of 43 nursing homes.

Health inspections

Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.

Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 55 health citations on file.

Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
2G
0H
0I
Potential for more than minimal harm
38D
14E
1F
Potential for minimal harm
0A
0B
0C
February 27, 2026Standard inspection, Complaint inspection · 18 citations
  1. E
    Honor the resident's right to organize and participate in resident/family groups in the facility.
    F565 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review, it was determined the facility failed to effectively respond to resident council concerns expressed at 3 of 3 resident council meetings reviewed for facility response to Resident Council concerns. This placed residents at risk for unmet needs concerning issues of resident care and lessened quality of life.
  2. E
    Ensure residents have reasonable access to and privacy in their use of communication methods.
    F576 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to have a system in place to deliver mail on Saturdays for 1 of 1 Resident Council reviewed. This placed residents at risk for lack of timely written communications.
  3. E
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to monitor residents and follow physician orders for 6 of 13 sampled residents (#'s 37, 48, 55, 62, 63, and 68) reviewed for abuse, staffing, and death. This placed residents at risk for unidentified concerns and unmet care needs.
  4. E
    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.
    F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation and interview it was determined the facility failed to ensure medications and biologicals were secured and accessible only to authorized personnel for 2 of 3 facility halls observed for secure medication cart. This placed residents at risk for misappropriation of medications and adverse medication consequences.
  5. E
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation, interview, and record review it was determined the facility failed to implement Enhance Barrier Precautions for 2 of 2 sampled residents (#s 11 and 48) reviewed for pressure ulcers. This placed residents at risk for cross contamination.
  6. D
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    F550 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review, it was determined that the facility failed to ensure care was provided in a manner that maintained resident dignity for 1 of 7 residents (#67) reviewed for abuse. This placed residents at risk for undignified care.
  7. D
    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
    F578 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to assist residents to formulate and obtain an advance directive for 2 of 3 sampled residents (#s 26 and 48) reviewed for advance directives. This placed residents at risk for healthcare decisions to conflict with resident wishes.
  8. D
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    F600 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure residents were not abused for 3 of 7 sampled residents (#s 48, 65 and 66) reviewed for abuse. This placed residents at risk for abuse and diminished psychosocial well-being.
  9. D
    Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
    F604 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation, interview, and record review it was determined the facility failed to assess the use of a physical restraint for 1 of 2 sampled resident (#12) reviewed for positioning and mobility. This placed residents at risk for inappropriate use of a restraint.
  10. D
    Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
    F605 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation, interview, and record review it was determined the facility failed to obtain a baseline assessment for 1 of 5 sampled residents (#2) reviewed for unnecessary medications. This placed residents at risk for unidentified adverse medication side effects.
  11. D
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    F609 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interviews and record review it was determined the facility failed to report allegations of abuse within the mandated timeframe for 3 of 4 sampled residents (#s 6, 65 and 66) for 1 of 5 FRI reports reviewed for abuse. This placed residents at risk for further abuse.
  12. D
    Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
    F628 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to provide a bed hold policy for 1 of 1 sampled resident (#62) reviewed for hospitalization. This placed residents at risk for not being informed of their right to return to the facility.
  13. D
    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
    F636 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation, interview, and record review it was determined the facility failed to complete a comprehensive assessment for 2 of 7 sampled residents (#s 2 and 48) reviewed for pressure ulcer and unnecessary medications. This placed residents at risk for adverse side effects and worsening wounds.
  14. D
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    F677 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation, interview, and record review it was determined the facility failed to ensure dependent residents received required assistance with ADL care for 2 of 2 sampled residents (#s 12 and 32) reviewed for ADL care. This placed residents at risk for lack of personal hygiene.
  15. D
    Provide activities to meet all resident's needs.
    F679 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to provide resident centered activities for 1 of 1 sampled resident (#7) reviewed for activities. This placed residents at risk for diminished psychosocial well-being and quality of life.
  16. D
    Provide appropriate pressure ulcer care and prevent new ulcers from developing.
    F686 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on observation, interview, and record review it was determined the facility failed to ensure pressure ulcer care was provided to promote healing and physician orders were followed for 2 of 2 sampled residents (#s 11 and 48) reviewed for pressure ulcers. This placed residents at risk for delayed healing.
  17. D
    Provide safe, appropriate dialysis care/services for a resident who requires such services.
    F698 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to perform pre and post dialysis assessments on 1 of 1 resident (#3) reviewed for dialysis. This placed residents at risk for inadequate monitoring.
  18. D
    Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
    F847 · Administration · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2026
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure a resident or representative understood an arbitration agreement before signing for 2 of 3 sampled residents (#s 3 and 21). This placed residents at risk for inability to resolve concerns in court.
July 11, 2025Complaint inspection · 2 citations
  1. E
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) August 18, 2025
    Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to provide care in accordance with professional standards and failed to ensure care needs were met for 3 of 3 sampled residents (#s 1, 3 and 5) reviewed for call lights. This placed residents at risk for unmet care needs.
  2. D
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) August 18, 2025
    Inspectors wroteBased on interview and record review, it was determined that the facility failed to implement care plan interventions for aspiration precautions for 1 of 3 sampled residents (#6) reviewed for respiratory services and aspiration precautions. This placed residents at risk for a lack of nutritional assistance and aspiration.
October 29, 2024Standard inspection, Complaint inspection · 15 citations
  1. G
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · Actual harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure residents' change of condition was assessed timely for 2 of 2 residents (#s 8 and 22) reviewed for skin conditions. This failure resulted in Resident 8 experiencing untreated and significant pain, sustaining multiple fractures and receiving treatment at the hospital.
  2. G
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · Actual harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to assess for care plan effectiveness, identify and implement new fall interventions or provide adequate supervision needed to prevent falls for 3 of 3 sampled residents (#s 40, 48 and 108) reviewed for falls. This failure resulted in Resident 108's hospitalization and placed residents at risk for falls and injury.
  3. E
    Honor the resident's right to organize and participate in resident/family groups in the facility.
    F565 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure residents were provided with the opportunity to organize and participate in Resident Council for 1 of 1 facility reviewed for Resident Council. This placed residents at risk for a lack of participation in group discussions regarding facility policies, procedures and resident rights.
  4. E
    Ensure the activities program is directed by a qualified professional.
    F680 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to provide a qualified professional to direct the activities program for 1 of 1 facility reviewed for activities. This placed residents at risk for unmet physical, mental and psychosocial needs.
  5. E
    Observe each nurse aide's job performance and give regular training.
    F730 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to complete nurse aide performance reviews every twelve months for 5 of 5 sampled CNAs (#s 5, 6, 7, 8 and 9) reviewed for staffing. This placed residents at risk for a lack of care by competent staff.
  6. E
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation and interview it was determined the facility failed to properly store laundry to prevent cross contamination for 1 of 1 facility reviewed for infection control. This placed residents at risk for cross contamination and the potential spread of infection.
  7. D
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    F550 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on interview, and record review it was determined the facility failed to ensure a resident was treated in a dignified manner and free from a derogatory slur for 1 of 4 sampled residents (#110) reviewed for dignity. This placed residents at risk for being treated in a disrespectful manner.
  8. D
    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.
    F584 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure residents' bed mattresses were in good repair for 1 of 1 sampled resident (#5) reviewed for restraints and a comfortable environment free from offensive odors for 1 of 1 facility observed for environment. This placed residents at risk for an uncomfortable environment.
  9. D
    Ensure each resident receives an accurate assessment.
    F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure accurate assessments for 3 of 7 sampled residents (#s 14, 22 and 45) reviewed for communication, dental and ADLs. This placed residents at risk for unmet care needs.
  10. D
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    F644 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to complete a PASARR (Preadmission Screening and Resident Review) Level II evaluation for residents with a positive Level I PASARR for 1 of 1 resident (#22) reviewed for PASARR. This placed residents at risk for unmet behavioral and emotional needs and a decrease in their quality of life.
  11. D
    Provide activities to meet all resident's needs.
    F679 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to provide an ongoing person-centered activity program for 2 of 3 sampled dependent residents (#s 40 and 48 ) reviewed for activities. This placed residents at risk of a decline in psychosocial well-being and diminished quality of life.
  12. D
    Provide safe, appropriate pain management for a resident who requires such services.
    F697 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to provide appropriate and timely pain management for 1 of 3 sampled residents (#22) reviewed for pain. This placed residents at risk for pain.
  13. D
    Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
    F740 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to obtain necessary services for the behavioral health care needs of residents and review and revise behavioral health care plan interventions to ensure interventions were appropriate and effective for 1 of 1 resident (#22) reviewed for PASARR (Preadmission Screening and Resident Review). This placed residents at risk for unmet behavioral health care needs and for not attaining their highest practicable well-being.
  14. D
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    F842 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure the correct POLST was readily available and accessible to enable staff to provide the appropriate interventions for 1 of 5 residents (#42) reviewed for choices. This placed residents at risk for not receiving care per their current wishes.
  15. D
    Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
    F849 · Administration · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 28, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to establish an effective communication process between the facility and hospice provider in order to ensure the needs of the resident were addressed and met 24 hours per day for 1 of 1 resident (#48) reviewed for hospice. This placed residents at risk for unmet needs. The facility's 9/2017 Hospice Policy revealed the following: -The hospice and facility communicate, establish and agree upon a coordinated Plan of Care (POC) reflecting the hospice philosophy and based on an evaluation of the individual needs of the resident. -Hospice establishes the POC related to the terminal illness, related conditions, directives for management of pain and other uncomfortable symptoms. -The facility maintains a POC that is consistent with the hospice POC. [...]
March 21, 2024Complaint inspection · 1 citation
  1. D
    Prepare residents for a safe transfer or discharge from the nursing home.
    F624 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 12, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure a safe and orderly discharge for 1 of 3 sampled residents (#103) reviewed for discharge. This placed residents at risk for an unsafe discharge related to medication needs.
February 9, 2024Complaint inspection · 3 citations
  1. F
    Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
    F727 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, widespread · found on a complaint visit · Corrected (the home has a date of correction) March 11, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure an RN was available for at least eight consecutive hours per day seven days per week for 4 of 68 days reviewed for staffing. This placed residents at risk for lack of timely RN assessments and care.
  2. E
    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
    F725 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) March 11, 2024
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure sufficient staffing to meet resident care needs for 1 of 1 facility reviewed for sufficient staffing. This placed residents at risk for unmet care needs and lengthy call light response times.
  3. E
    Post nurse staffing information every day.
    F732 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) March 11, 2024
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure the Direct Care Staff Daily Report (DCSDR) postings were complete and accurately reflected actual staff working for 25 of 68 days reviewed for sufficient staffing. This placed residents at risk for incorrect staffing information.
July 17, 2023Standard inspection · 16 citations
  1. E
    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.
    F584 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure a well maintained and homelike resident rooms for 2 of 3 halls reviewed for environment. This placed residents at risk for a non-homelike environment.
  2. E
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wrote1. Based on observation, interview and record review it was determined the facility failed to ensure resident shared equipment was appropriately disinfected for 3 of 3 halls reviewed for infection control. This placed residents at risk for spread of infection.
  3. D
    Allow residents to self-administer drugs if determined clinically appropriate.
    F554 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure residents were assessed for safe self-administration of medications for 1 of 1 sampled residents (#29) reviewed for self-administration of medications. This placed residents at risk for adverse medication side effects.
  4. D
    Ensure each resident receives an accurate assessment.
    F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review the facility failed to accurately code the MDS for 3 of 4 sampled residents (#s 17, 18 and 29) reviewed for positioning and dental. This placed residents at risk for unmet needs.
  5. D
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to develop and implement care plans for 1 of 1 sampled resident (#35) reviewed for communication. This placed residents at risk for unmet needs.
  6. D
    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
    F657 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on interview and record review the facility failed to revise the care plan for 1 of 4 sampled residents (#9) reviewed for nutrition. This placed residents at risk for unmet needs.
  7. D
    Ensure services provided by the nursing facility meet professional standards of quality.
    F658 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure Staff 12 (LPN) adhered to professional nursing standards related to provision of medications for 1 of 1 sampled resident (#150) during a medication administration observations. This placed residents at risk for not receiving ordered medications.
  8. D
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    F677 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wrote2. Resident 29 was admitted to the facility in 6/2020 with diagnoses including hemiplegia (a severe or complete loss of strength or paralysis on one side of the body) and hemiparesis (a mild or partial weakness or loss of strength on one side of the body) following a stroke. Resident 29's 9/22/22 ADL Self-Care Performance Deficit Care Plan revealed the following: - Nail care per licensed nurse. The resident was diabetic. - Report to licensed nurse if the resident was in need of nail care. Resident 29's 6/8/23 Quarterly MDS revealed the resident experienced short and long term memory loss, was severely impaired for decision-making and required extensive assistance from one person with dressing, personal hygiene and bed mobility. Resident 29's 7/2023 Physician Orders indicated diabetic nail care was to be performed by a licensed nurse weekly. [...]
  9. D
    Provide activities to meet all resident's needs.
    F679 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to develop and implement an activity care plan and failed to include residents in group and individual activities for 2 of 4 sampled residents (#s 26 and 35) reviewed for activities. This placed residents at risk for isolation and lack of social interaction and engagement.
  10. D
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to follow physician orders for 1 of 4 sampled residents (#11) reviewed for skin issues and positioning. This placed residents at risk for lack of necessary treatment.
  11. D
    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.
    F688 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to provide appropriate treatment and services to prevent further decrease in range in motion for 1 of 3 sampled residents (#29) reviewed for position and mobility. This placed residents at risk for worsening contractures (a permanent tightening of the muscle, tendons and skin causing the joint to shorten and stiffen) and conditions.
  12. D
    Provide safe, appropriate dialysis care/services for a resident who requires such services.
    F698 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to monitor physician-ordered fluid restrictions for 1 of 1 sampled resident (#250) reviewed for dialysis care. This placed residents at risk for complications related to dialysis.
  13. D
    Ensure medication error rates are not 5 percent or greater.
    F759 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to ensure a medication error rate of less than 5%. There were seven errors out of 26 opportunities resulting in a 26.92% error rate. This placed residents at risk for adverse medication effects.
  14. D
    Provide routine and 24-hour emergency dental care for each resident.
    F790 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on observation, interview and record review it was determined the facility failed to provide routine dental services for 1 of 1 sampled resident (#17) reviewed for dental care. This placed residents at risk of unmet dental needs.
  15. D
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    F842 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure resident records were accurate related to medication administration for 1 of 7 sampled residents (#150) reviewed for medication administration. This placed residents at risk for inaccurate health records.
  16. D
    Develop and implement policies and procedures for flu and pneumonia vaccinations.
    F883 · Infection Control · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 16, 2023
    Inspectors wroteBased on interview and record review it was determined the facility failed to ensure residents were offered and received the pneumococcal vaccination according to Center for Disease Control and Prevention (CDC) guidelines for 2 of 5 sampled residents (#s 8 and 11) reviewed for immunizations. This placed residents at risk for acquiring pneumonia.

Fire safety inspections

6 fire safety citations on file: 3 on February 27, 2026, 1 on October 29, 2024, 2 on July 17, 2023.

Every fire safety citation6 citations
  1. F
    Address patient/client population and determine types of services needed.
    E 7 · February 27, 2026 · Corrected (the home has a date of correction)
  2. F
    Develop Emergency Preparedness policies and procedures.
    E 13 · February 27, 2026 · Corrected (the home has a date of correction)
  3. F
    Meet other general requirements that are deficient.
    K 500 · February 27, 2026 · Corrected (the home has a date of correction)
  4. D
    Ensure proper usage of power strips and extension cords.
    K 920 · October 29, 2024 · Corrected (the home has a date of correction)
  5. F
    Have simulated fire drills held at unexpected times.
    K 712 · July 17, 2023 · Corrected (the home has a date of correction)
  6. D
    Properly select, install, inspect, or maintain portable fire extinguishes.
    K 355 · July 17, 2023 · Corrected (the home has a date of correction)

Fines and payment denials

DatePenaltyAmount or length
October 29, 2024Fine $24,827

A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

MeasureThis homeOregonUnited States
All nursing staff (RN, LPN and aides)4.685.033.86
Registered nurses0.880.720.69
All nursing staff on weekends4.084.513.42
Nurse aides3.09
Licensed practical nurses0.72
Nursing staff turnover (share who left in a year)50.0%47.4%45.8%
Registered nurse turnover53.3%51.6%42.9%
Administrators who left0

CMS expects 3.52 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.93 on weekdays and 4.08 on weekends, 17% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 2.6% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.56 in April to June 2025 to 4.68 in January to March 2026.

QuarterAll nursing staffRegistered nursesWeekdaysWeekendsContract staff shareDays with no RN hoursResidents a day
Jan to Mar 20264.680.884.934.08 2.6%0 of 9055
Oct to Dec 20254.540.864.744.03 2.0%0 of 9255
Jul to Sep 20254.550.824.803.90 4.9%1 of 9254
Apr to Jun 20254.560.844.813.96 3.9%1 of 9153
United States, Jan to Mar 20263.750.623.923.335.3%0.5% of days
Oregon, Jan to Mar 20264.910.645.124.406.2%0.4% of days

Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.

Staff pay reports

Staff pay at this home

No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.

Official wage estimates for Oregon

JobMedianMiddle halfEmployed
Oregon, all employers
CNAs (nursing assistants)$23.96$22.83 to $28.4014,800
LPNs and LVNs$38.69$35.11 to $43.604,260
Registered nurses$62.02$51.55 to $64.6339,730
United States, nursing care facilities
CNAs (nursing assistants)$20.67$17.91 to $22.55534,270
LPNs and LVNs$33.86$30.05 to $37.40188,210
Registered nurses$41.11$37.85 to $47.68142,270

Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.

How staff pay reports work · CNA pay by state

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

MeasureThis homeOregonUS
Percentage of long-stay residents whose need for help with daily activities has increased
Long Stay residents, 2025Q2-2026Q1
9.314.913.9
Percentage of long-stay residents with a catheter inserted and left in their bladder
Long Stay residents, 2025Q2-2026Q1
0.01.40.8
Percentage of long-stay residents with a urinary tract infection
Long Stay residents, 2025Q2-2026Q1
0.62.01.6
Percentage of long-stay residents experiencing one or more falls with major injury
Long Stay residents, 2025Q2-2026Q1
0.62.43.2
Percentage of short-stay residents who newly received an antipsychotic medication
Short Stay residents, 2025Q2-2026Q1
0.01.41.6
Percentage of long-stay residents whose ability to walk independently worsened
Long Stay residents, 2025Q2-2026Q1
16.120.614.1
Percentage of long-stay residents with pressure ulcers
Long Stay residents, 2025Q2-2026Q1
6.85.84.6
Percentage of long-stay residents who received an antipsychotic medication
Long Stay residents, 2025Q2-2026Q1
24.613.915.4

Short-term rehab results

For a stay to recover after a hospital visit, these are the results CMS publishes for Portland Health and Rehabilitation's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (54.4% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.

Went home or back to the community

54.4% this home

No different from the national rate

US median of homes 51.5% · Oregon: 52 better, 3 worse

Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 48 eligible stays.

Potentially preventable readmissions

10.2% this home

No different from the national rate

US median of homes 10.7% · Oregon: 3 better, 0 worse

Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 42 eligible stays.

Infections that led to a hospital stay

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

US median of homes 7.1% · Oregon: 0 better, 0 worse

Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 19 eligible stays.

Self-care and mobility at discharge

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

Median of homes: Oregon59.2% · US 56.6%

Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 5 residents counted.

Falls with major injury

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

Median of homes: Oregon0.0% · US 0.0%

Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 8 residents counted.

New or worsened pressure ulcers

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

Median of homes: Oregon2.6% · US 1.7%

Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 8 residents counted.

Medication list given at discharge

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

Median of homes: Oregon98.5% · US 98.7%

Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 1 residents counted.

Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.

Owners and operators

Legal business name: PORTLAND SNF OPERATIONS LLC. CMS links this home to Evergreen Healthcare Group, a group of 43 nursing homes averaging 2.4 stars overall.

NameRoleTypeShareSince
Pacific Northwest SNF Operations Holdings (or) LLCDirect ownership interestOrganization08/31/2023
Portland SNF Operations LLCDirect ownership interestOrganization08/31/2023
Ch Pacific Northwest Holdings LLCIndirect ownership interestOrganization08/31/2023
Pacific Northwest SNF Operations Holdings LLCIndirect ownership interestOrganization08/31/2023
Witzcorp Global LLCIndirect ownership interestOrganization08/31/2023
Herzka, YisroelIndirect ownership interestIndividual08/31/2023
Yenowitz, YitzchokIndirect ownership interestIndividual08/31/2023
Cepeda, MyleneManaging control - governing bodyIndividual08/31/2023
Odenthal, JasonManaging control - governing bodyIndividual08/31/2023
Couve Financial Services LLCOperational/managerial controlOrganization08/31/2023
Couve Healthcare Consulting LLCOperational/managerial controlOrganization08/31/2023
Oregon SNF Consulting LLC (de)Operational/managerial controlOrganization08/31/2023
Pacific Northwest Opco Management LLCOperational/managerial controlOrganization08/31/2023
Portland SNF Operations LLCOperational/managerial controlOrganization08/31/2023
Ceesay, BasiruOperational/managerial controlIndividual08/31/2023
Dezember, DuffyOperational/managerial controlIndividual08/31/2023
Morris, ChristopherOperational/managerial controlIndividual08/31/2023
Odenthal, JasonOperational/managerial controlIndividual08/31/2023
Spielman, ShimonOperational/managerial controlIndividual08/31/2023
Yenowitz, YitzchokOperational/managerial controlIndividual08/31/2023
Ch Pacific Northwest Holdings LLCAdp of the SNFOrganization08/31/2023
Couve Financial Services LLCAdp of the SNFOrganization08/31/2023
Couve Healthcare Consulting LLCAdp of the SNFOrganization03/31/2025
Oregon SNF Consulting LLC (de)Adp of the SNFOrganization04/01/2025
Pacific Northwest Opco Management LLCAdp of the SNFOrganization04/01/2025
Portland SNF Operations LLCAdp of the SNFOrganization06/18/2025
Witzcorp Global LLCAdp of the SNFOrganization08/31/2023
Ceesay, BasiruAdp of the SNFIndividual08/31/2023
Cepeda, MyleneAdp of the SNFIndividual08/31/2023
Dezember, DuffyAdp of the SNFIndividual08/31/2023
Herzka, YisroelAdp of the SNFIndividual08/31/2023
Morris, ChristopherAdp of the SNFIndividual08/31/2023
Odenthal, JasonAdp of the SNFIndividual08/31/2023
Spielman, ShimonAdp of the SNFIndividual08/31/2023
Yenowitz, YitzchokAdp of the SNFIndividual08/31/2023

As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.

Questions to ask on a visit

Chosen from this home's own inspection record.

  1. How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 19 problems in this area, most recently on February 27, 2026: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
  2. How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 11 problems in this area, most recently on February 27, 2026: "Honor the resident's right to organize and participate in resident/family groups in the facility."
  3. When is the care plan meeting, and can family attend it?Inspectors cited 9 problems in this area, most recently on February 27, 2026: "Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months."
  4. What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 4 problems in this area, most recently on February 27, 2026: "Provide and implement an infection prevention and control program."
  5. Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 4.08 hours per resident per day, below the Oregon average of 4.51.

Other nursing homes nearby

Oregon contacts for a concern about a nursing home

These are the official offices in Oregon. NursingHomeClear cannot take or act on complaints.

Common questions

What is Portland Health and Rehabilitation's Medicare star rating?
CMS rates Portland Health and Rehabilitation 1 out of 5 stars overall, with 1 for health inspections, 4 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Portland Health and Rehabilitation get at its last inspection?
18 health deficiencies at the standard inspection on February 27, 2026. The Oregon average is 9.2.
Has Portland Health and Rehabilitation been fined?
Yes. CMS lists 1 fine totaling $24,827 in the last three years.
Does Portland Health and Rehabilitation accept Medicaid?
It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Portland Health and Rehabilitation?
CMS lists 35 owners and managers, and links the home to Evergreen Healthcare Group. Legal business name: PORTLAND SNF OPERATIONS LLC.

Sources

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