Starfile / Oregon

GRESHAM POST ACUTE CARE AND REHABILITATION

405 NE 5TH STREET, GRESHAM, OR 97030 · CCN 385190

Inspection history vs Oregon & national averages

Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.

Cycle 1 deficiencies by category

Staffing (hours per resident per day)

Fines & penalties

Total fines

$136,749

Number of fines

3

Number of penalties

3

Payment denials

0

Chain

Chain

SAPPHIRE HEALTH SERVICES

Facilities in chain

8

Chain avg overall

1.80 / 5

Inspection citations (52)2 immediate jeopardy4 actual harm

1. DF0552Ensure that residents are fully informed and understand their health status, care and treatments.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

2. DF0558Reasonably accommodate the needs and preferences of each resident.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

3. DF0584Honor 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.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

4. DF0604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

5. DF0641Ensure each resident receives an accurate assessment.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

6. DF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

7. DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

8. DF0685Assist a resident in gaining access to vision and hearing services.2025-12-19 · Health · corrected 2026-01-22

   Potential for more than minimal harm

9. GF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2025-12-19 · Health · corrected 2026-01-22

   Actual harm

10. DF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

11. DF0692Provide enough food/fluids to maintain a resident's health.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

12. DF0695Provide safe and appropriate respiratory care for a resident when needed.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

13. DF0699Provide care or services that was trauma informed and/or culturally competent.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

14. DF0700Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

15. DF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

16. DF0759Ensure medication error rates are not 5 percent or greater.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

17. DF0761Ensure 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.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

18. DF0880Provide and implement an infection prevention and control program.2025-12-19 · Health · corrected 2026-01-22

    Potential for more than minimal harm

19. DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-11-24 · Health · corrected 2025-12-04

    Potential for more than minimal harm

20. GF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-06-17 · Health · corrected 2025-07-01

    Actual harm

21. DF0552Ensure that residents are fully informed and understand their health status, care and treatments.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

22. DF0623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

23. DF0625Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

24. DF0641Ensure each resident receives an accurate assessment.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

25. DF0655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

26. DF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

27. DF0658Ensure services provided by the nursing facility meet professional standards of quality.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

28. GF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2024-08-30 · Health · corrected 2024-10-14

    Actual harm

29. DF0695Provide safe and appropriate respiratory care for a resident when needed.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

30. DF0758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

31. FF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

32. EF0947Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.2024-08-30 · Health · corrected 2024-10-14

    Potential for more than minimal harm

33. DF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2023-10-31 · Health · corrected 2023-12-05

    Potential for more than minimal harm

34. DF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

35. DF0578Honor 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.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

36. DF0582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

37. DF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

38. DF0679Provide activities to meet all resident's needs.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

39. DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

40. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

41. DF0687Provide appropriate foot care.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

42. JF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2023-05-23 · Health · corrected 2023-06-22

    Immediate jeopardy

43. DF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

44. DF0698Provide safe, appropriate dialysis care/services for a resident who requires such services.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

45. JF0725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.2023-05-23 · Health · corrected 2023-06-22

    Immediate jeopardy

46. DF0727Have 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.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

47. EF0730Observe each nurse aide's job performance and give regular training.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

48. DF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

49. DF0761Ensure 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.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

50. DF0825Provide or get specialized rehabilitative services as required for a resident.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

51. DF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.2023-05-23 · Health · corrected 2023-06-22

    Potential for more than minimal harm

52. IF0865Have a plan that describes the process for conducting QAPI and QAA activities.2023-05-23 · Health · corrected 2023-06-22

    Actual harm

Ownership

Other facilities in GRESHAM

Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.