Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385164 Aidan Senior Living at Reedsport 600 Ranch Rd Reedsport, OR 97467 County: Douglas Roseburg AAA Coos Bay/Reedsport

Yes

Yes

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

[email protected]

Capacity:

CCMU Tualatin

156

Other Service:

RCF 20, ALF 85 Administrator: Becky Griffin Facility Phone (541) 773-7717

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 857-5139 Waterford Operations, LLC Operator: Waterford Operations, LLC Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin RCF 63 Administrator: Cheryl LaCombe-Anderson Facility Phone (503) 393-3624 Orig Lic. Date 11/18/1993 69

Other Service:

: Facility Fax:

(503) 393-0108 Keizer Campus Operations, LLC Operator: Keizer Campus Operations, LLC Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

127

Other Service: Administrator:

Nate Dawson

Facility Phone (503) 244-7533 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 244-2396 Owner: Crestview Operations, LLC Operator: Crestview Operations, LLC

Medicaid Withdrawal: No

385195 Avamere Rehabilitation of Beaverton 11850 SW Allen Blvd Beaverton, OR 97005 County: Washington WCDAVS Beaverton DSO

Valerie Hunter

Facility Phone (541) 271-5841 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 271-6357 Owner: Aidan Senior Living at Reedsport, Inc Operator: Aidan Senior Living at Reedsport, Inc

Medicaid Withdrawal: No

385031 Avamere Crestview of Portland 6530 SW 30th Avenue Portland, OR 97239 County: Multnomah Multnomah Co NF Unit

CCMU Tualatin

36

Administrator:

Medicaid Withdrawal: No

385233 Avamere Court at Keizer 5210 River Rd N Keizer, OR 97303 County: Marion Salem NWSDS Salem DSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385126 Avamere at Three Fountains 835 Crater Lake Ave Medford, OR 97504 County: Jackson Medford SSO Medford DSO

ADMINISTRATOR, PHONE

Email:

Yes

Yes

Capacity:

[email protected] CCMU Tualatin

104

Other Service: Administrator:

Jonathan Mack

Facility Phone (503) 646-7164 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 646-5105 Owner: Beaverton Rehab & Specialty Care, LLC Operator: Beaverton Rehab & Specialty Care, LLC Email:

[email protected]

Page 1 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385203 Yes Avamere Rehabilitation of Clackamas 220 East Hereford Gladstone, OR 97027 County: Clackamas Clackamas AAA

Yes

Yes

CCMU Tualatin

92 Kari Head

Orig Lic. Date 01/21/1969 Facility Phone (541) 267-2161 : Facility Fax: (541) 267-0543 Owner: Coos Bay Rehabilitation, LLC. Operator: Coos Bay Rehabilitation, LLC. Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

123

Other Service: Administrator:

Jenna Corbly

Facility Phone (541) 687-1310 Orig Lic. Date 11/15/1965 : Facility Fax: (541) 687-6913 Owner: Eugene Rehabilitation, LLC. Operator: Eugene Rehabilitation, LLC. Email:

Yes

Yes 385229 Avamere Rehabilitation of Junction City 530 Birch St Junction City, OR 97448 County: Lane Eugene SSO

Wednesday, December 05, 2012

Capacity:

Administrator:

Yes

[email protected]

Capacity:

CCMU Tualatin

100

Other Service: Administrator:

Brad Litle

Facility Phone (503) 648-8588 : Facility Fax: (503) 640-2810 Owner: Peckham-Miller, Inc. dba Operator: Peckham-Miller, Inc.

Medicaid Withdrawal: No

Medicaid Withdrawal: No

[email protected]

Other Service:

Medicaid Withdrawal: No

385251 Avamere Rehabilitation of Hillsboro 650 SE Oak St Hillsboro, OR 97123 County: Washington WCDAVS Beaverton DSO

Jeanette Kenney

Facility Phone (503) 656-0393 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 656-3251 Owner: Clackamas Rehabilitation , LLC. Operator: Clackamas Rehabilitation, LLC. Email:

Yes

CCMU Tualatin

87

Administrator:

Medicaid Withdrawal: No

385053 Avamere Rehabilitation of Eugene 2360 Chambers St Eugene, OR 97405 County: Lane Eugene SSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385239 Avamere Rehabilitation of Coos Bay 2625 Koos Bay Blvd Coos Bay, OR 97420 County: Coos Coos Bay MSO

ADMINISTRATOR, PHONE

Email:

Yes

Orig Lic. Date 06/01/1983

[email protected]

Capacity:

72

CCMU Tualatin

Other Service:

DayCare 10 Administrator: Jonathan Ramey Facility Phone (541) 998-2395

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 998-3950 Junction City Rehabilitation, LLC. Operator: Junction City Rehabilitation, LLC. Email: [email protected] Owner:

Page 2 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385132 Avamere Rehabilitation of King City 16485 SW Pacific Hwy Tigard, OR 97224 County: Washington Hillsboro WCDAVS Beaverton DSO

Yes

Yes

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

117

Other Service: Administrator:

Linda Learn

Orig Lic. Date 06/01/1983 Facility Phone (541) 259-1221 : Facility Fax: (541) 258-6288 Owner: Lebanon Care Center, LLC Operator: Lebanon Care Center, LLC Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

80

Other Service:

DayCare 10 Administrator: Yvonne Yates Facility Phone (541) 265-5356

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 574-0092 Newport Rehabilitation, LLC. Operator: Newport Rehabilitation, LLC. Email: [email protected] Owner:

Yes

Capacity:

Administrator:

Trevor Wart

Facility Phone (503) 656-0367 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 650-8136 Owner: Mountain View Rehab, LLC Operator: Mountain View Rehab, LLC Email:

Yes

CCMU Tualatin

95

Other Service:

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Orig Lic. Date 06/01/1983

Operator: King City Rehab, LLC Email:

385125 Yes Avamere Rehabilitation of Oregon City 1400 Division St Oregon City, OR 97045 County: Clackamas Clackamas AAA

Medicaid Withdrawal: No

Rick Samuelson

Facility Phone (503) 620-5141 : Facility Fax: (971) 223-0410 Owner: King City Rehab, LLC

Medicaid Withdrawal: No

385234 Avamere Rehabilitation of Salem 4120 Kurth St South Salem, OR 97302 County: Marion Salem NWSDS Salem DSO

CCMU Tualatin

148

Administrator:

Medicaid Withdrawal: No

385162 Avamere Rehabilitation of Newport 835 SW 11th Newport, OR 97365 County: Lincoln Toledo/Lincoln SSO Newport DSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385168 Avamere Rehabilitation of Lebanon 350 S 8th St Lebanon, OR 97355 County: Linn Albany SSO Lebanon DSO

ADMINISTRATOR, PHONE

Yes

Capacity:

[email protected] CCMU Tualatin

72

Other Service: Administrator:

Andy Becker

Facility Phone (503) 581-8667 Orig Lic. Date 04/12/1957 : Facility Fax: (503) 585-8046 Owner: South Salem Rehabilitation, LLC. Operator: South Salem Rehabilitation, LLC. Email:

[email protected]

Page 3 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385185 Avamere Riverpark of Eugene 425 Alexander Loop Eugene, OR 97401 County: Lane Eugene SSO

Yes

Yes

Email:

Yes

Yes

Capacity:

CCMU Tualatin

48

DayCare 5 Administrator: John Buckley Facility Phone (541) 367-2191

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 367-2630 Twin Oaks Rehab, LLC. Operator: Twin Oaks Rehab, LLC. Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

84

Other Service:

RCF 91 Administrator: Andrea Sessions Facility Phone (541) 756-4151

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 751-7715 Bay Area Properties, LLC Operator: Radiant Senior Living, Inc. Email: [email protected] Owner:

No

Yes 385219 Care Center East Health & Specialty Care Center 11325 NE Weidler Portland, OR 97220 County: Multnomah Multnomah Co NF Unit

Wednesday, December 05, 2012

[email protected]

Other Service:

Yes

Capacity:

CCMU Tualatin

48

Other Service:

DayCare 6 Administrator: Judy Martin Facility Phone (541) 820-3341

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 820-3628 Blue Mountain Hospital District Operator: Blue Mountain Hospital District Email: [email protected] Owner:

Medicaid Withdrawal: No

Medicaid Withdrawal: No

Chad Martin

Facility Phone (541) 345-6199 Orig Lic. Date 10/27/1993 : Facility Fax: (541) 345-6721 Owner: Riverpark Operations, LLC Operator: Riverpark Operations, LLC

Medicaid Withdrawal: No

38E040 Blue Mountain Nursing Home 112 E Fifth St-PO Box 305 Prairie City, OR 97869 County: Grant John Day MSO John Day MSO

CCMU Tualatin

119

Administrator:

Medicaid Withdrawal: No

385039 Baycrest Health Center 3959 Sheridan Ave North Bend, OR 97459 County: Coos Coos Bay MSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385242 Avamere Twin Oaks of Sweet Home 950 Nandina Street Sweet Home, OR 97386 County: Linn Albany SSO Lebanon DSO

ADMINISTRATOR, PHONE

Yes

Capacity:

CCMU Tualatin

93

Other Service: Administrator:

Shirley Dethloff

Facility Phone (503) 253-1181 : Facility Fax: (503) 253-1871 Owner: Extendicare Homes, Inc. Operator: Extendicare Homes, Inc. Email:

Orig Lic. Date 09/15/1959

[email protected]

Page 4 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 38L756 Cascade Manor 65 West 30th Eugene, OR 97405 County: Lane Eugene SSO

LICENSED CAPACITY MEDICARE MEDICAID Yes

No

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Orig Lic. Date 02/01/1967

Operator: Pacific Retirement Services, Inc. Email: [email protected]

Yes

Yes

Capacity:

CCMU Tualatin

105

Other Service: Administrator:

Amanda Pearlman

Orig Lic. Date 11/15/1993 Facility Phone (503) 761-3181 : Facility Fax: (503) 760-6556 Owner: Care Center (Cascade Terrace) Inc. Operator: Prestige Care, Inc. Email:

No

Yes

[email protected]

Capacity:

CCMU Tualatin

87

Other Service:

ACU 20 Administrator: Margaret Tucker Facility Phone (541) 382-7161

Orig Lic. Date 02/05/1968

: Facility Fax:

(541) 383-7662 BD Bend III, LLC Operator: Regency Pacific Management, LLC Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

99

Other Service:

ACU 20 Administrator: Bronson Ho Facility Phone (503) 538-2108

Orig Lic. Date 08/20/1953

: Facility Fax:

(503) 538-1768 Care Center (Chehalem) Inc. Operator: Prestige Care, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385144 Clatsop Care Center 646 16th St Astoria, OR 97103 County: Clatsop Astoria NWSDS Seaside DSO

Brian Young

Facility Phone (541) 342-5901 : Facility Fax: (541) 342-5909 Owner: Cascade Manor, Inc.

Medicaid Withdrawal: No

385199 Chehalem Health & Rehab Center 1900 E Fulton St Newberg, OR 97132 County: Yamhill McMinnville NWSDS McMinnville DSO

CCMU Tualatin

32

Administrator:

Medicaid Withdrawal: No

38E032 Cascade View Nursing Center 119 SE Wilson Ave Bend, OR 97702 County: Deschutes Bend MSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385187 Cascade Terrace Nursing Center 5601 SE 122nd Portland, OR 97236 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Yes

Yes

Capacity:

CCMU Tualatin

71

Other Service: Administrator:

Anita Schacher

Facility Phone (503) 325-0313 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 325-0115 Owner: Clatsop Care Center Health District Operator: Clatsop Care Center Health District Email:

[email protected]

Page 5 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385152 Coast Fork Nursing Center 515 Grant St. Cottage Grove, OR 97424 County: Lane Eugene SSO

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

ADMINISTRATOR, PHONE Capacity:

CCMU Tualatin

80

Other Service: Administrator:

Sarah Sims

Facility Phone (541) 942-5528 Orig Lic. Date 01/01/1984 : Facility Fax: (541) 942-2155 Owner: Coast Fork Nursing Center, Inc. Operator: Prestige Care, Inc.

Medicaid Withdrawal: No

385049 Columbia Basin Care Facility 1015 Webber Rd The Dalles, OR 97058 County: Wasco The Dalles MSO

Email:

Yes

Yes

Capacity:

CCMU Tualatin

120

Other Service: Administrator:

Ron Bell

Orig Lic. Date 01/12/1955 Facility Phone (541) 296-2156 : Facility Fax: (541) 298-1528 Owner: Wasco County Nursing Care, Inc. Operator: Aidan Health Services, Inc.

Medicaid Withdrawal: No

38E024 Columbia Care Center 33910 E Columbia Ave PO Box 1068 Scappoose, OR 97056 County: Columbia St Helens MSO

[email protected]

Email:

No

Yes

[email protected]

Capacity:

CCMU Tualatin

41

Other Service: Administrator:

Curtis Moyes

Facility Phone (503) 543-7131 : Facility Fax: (503) 543-5220 Owner: EEA Company

Orig Lic. Date 06/01/1983

Operator: EEA Company Medicaid Withdrawal: No

38E173 Cornerstone Care Option 12640 SE Bush Portland, OR 97236 County: Multnomah Multnomah Co NF Unit

Email:

No

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin

40

Other Service:

RCF 16 Administrator: Heather Riley Facility Phone (503) 761-6621

Orig Lic. Date 04/05/1954

: Facility Fax:

(503) 761-6633 Cornerstone Care Option, Inc Operator: Cornerstone Care Option, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385072 Yes Corvallis Manor Nursing & Rehabilitation Center 160 NE Conifer Blvd Corvallis, OR 97330 County: Benton Albany SSO Albany DSO

[email protected]

Yes

Capacity:

CCMU Tualatin

135

Other Service: Administrator:

Dewey Konopa

Facility Phone (541) 757-1651 : Facility Fax: (541) 757-1662 Owner: MCH Enterprises, Inc.

Orig Lic. Date 04/24/1967

Operator: Pinnacle Healthcare Management, Inc. Email:

[email protected]

Page 6 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385182 Yes Creswell Health and Rehabilitation Center 735 South 2nd St Creswell, OR 97426 County: Lane Eugene SSO

Yes

ADMINISTRATOR, PHONE Capacity:

Administrator:

Email:

Yes

Capacity:

CCMU Tualatin RCF 20,ALF 78, ACU 14 Administrator: Kelly Oldentgaard Orig Lic. Date 06/01/1983 Facility Phone (503) 623-5581 (503) 623-2901 Dallas Mennonite Retirement Community, Inc. Operator: Life Care Services LLC Email: [email protected] Owner:

Yes

Capacity:

Administrator:

Operator: Senior Housing Management, LLC

Capacity:

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Vernon Roberson, Prov

Facility Phone (541) 475-2273 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 475-4289 Owner: East Cascade Retirement Community, LLC

385217 Yes Yes EmpRes Hillsboro Health and Rehabilitation Center 1778 NE Cornell Rd Hillsboro, OR 97124 County: Washington WCDAVS Beaverton DSO

Medicaid Withdrawal: No

CCMU Tualatin

20

Other Service:

Email:

Yes

[email protected] CCMU Tualatin

78

Other Service: Administrator:

Sarah Tijerina

Facility Phone (503) 648-6621 Orig Lic. Date 10/31/1964 : Facility Fax: (503) 648-4443 Owner: Evergreen Oregon Healthcare Tualatin, L.L.C. Operator: EmpRes Healthcare Management, LLC Email:

Yes

121

: Facility Fax:

Medicaid Withdrawal: No

385064 Fair View Transitional Health Center 1710 NE Fairview Ave Grants Pass, OR 97526 County: Josephine Grants Pass MSO Grants Pass MSO

[email protected]

Other Service:

Medicaid Withdrawal: No

385181 Yes East Cascade Retirement Community, LLC 175 NE 16th St. Madras, OR 97741 County: Jefferson Bend MSO Madras MSO

Jeremiah Tolman

Facility Phone (541) 895-3333 Orig Lic. Date 02/03/1983 : Facility Fax: (541) 895-2209 Owner: Care Center (Laneco) Inc. Operator: Prestige Care Inc.

Medicaid Withdrawal: No

385207 Yes Dallas Retirement Village Health Center 377 NW Jasper Street Dallas, OR 97338 County: Polk McMinnville NWSDS Salem DSO

CCMU Tualatin

76

Other Service:

Capacity:

[email protected] CCMU Tualatin

102

Other Service: Administrator:

Grant Gloor

Facility Phone (541) 479-2606 : Facility Fax: (541) 471-0611 Owner: BD Grants Pass I, LLC

Orig Lic. Date 06/01/1983

Operator: Regency Pacific Management, LLC Email:

[email protected]

Page 7 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385237 Fernhill Estates 5737 NE 37th Portland, OR 97211 County: Multnomah Multnomah Co NF Unit

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

ADMINISTRATOR, PHONE Capacity:

CCMU Tualatin

63

Other Service: Administrator:

Don Snow

Facility Phone (503) 288-5967 : Facility Fax: (503) 287-4172 Owner: Fernhill Estates, LLC

Orig Lic. Date 10/22/1952

Operator: Dakavia Management, Corp. Medicaid Withdrawal: No

Email:

385155 Yes Forest Grove Rehabilitation and Care Center 3900 Pacific Ave Forest Grove, OR 97116 County: Washington WCDAVS Beaverton DSO

Yes

Orig Lic. Date 01/06/1976

: Facility Fax:

(503) 357-8086 PCI Care Venture I, Inc. Operator: Prestige Care, Inc. Email: [email protected] Owner:

Yes

Capacity:

CCMU Tualatin

80

Other Service: Administrator:

Karla Hunt

Facility Phone (503) 982-0111 : Facility Fax: (503) 982-2481 Owner: 3C2MD, Inc.

Orig Lic. Date 06/01/1983

Operator: Pinnacle Healthcare Management, Inc. Email:

Yes

CCMU Tualatin

114

ECU 10 Administrator: Gail Brockway Facility Phone (503) 359-0449

Medicaid Withdrawal: No

385121 Friendship Health Center 3320 SE Holgate Blvd Portland, OR 97202 County: Multnomah Multnomah Co NF Unit

Capacity:

Other Service:

Medicaid Withdrawal: No

385117 Yes French Prairie Nursing and Rehabilitation Center 601 Evergreen Rd Woodburn, OR 97071 County: Marion Woodburn NWSDS Salem DSO

[email protected]

Yes

[email protected]

Capacity:

CCMU Tualatin

100

Other Service: Administrator:

September Young

Facility Phone (503) 231-1411 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 239-1170 Owner: Friendship Health Center, Inc. Operator: Friendship Health Center, Inc.

Medicaid Withdrawal: No

38L565 Friendsview Manor 1301 E Fulton St Newberg, OR 97132 County: Yamhill McMinnville NWSDS McMinnville DSO Medicaid Withdrawal: No

Wednesday, December 05, 2012

Email:

No

No

[email protected]

Capacity:

29

CCMU Tualatin

Other Service:

RCF 44 Administrator: Sean Carey Facility Phone (503) 538-3144

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 538-6371 Friendsview Manor, Inc. Operator: Friendsview Manor, Inc. Email: [email protected] Owner:

Page 8 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385268 Gateway Care & Retirement Center 39 NE 102nd Portland, OR 97220 County: Multnomah Multnomah Co NF Unit

Yes

Yes

ADMINISTRATOR, PHONE Capacity:

CCMU Tualatin

59

Other Service: Administrator:

Allen James

Facility Phone (503) 252-2461 : Facility Fax: (503) 252-5060 Owner: Gateway, Inc.

Orig Lic. Date 06/01/1983

Operator: ALW, Inc. dba North West Healthcare Medicaid Withdrawal: No

385136 Glisan Care Center 9750 NE Glisan St Portland, OR 97220 County: Multnomah Multnomah Co NF Unit

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Jennifer Gray

Facility Phone (503) 256-3920 : Facility Fax: (503) 256-5489 Owner: Care Center (Glisan) Inc. Operator: Prestige Care, Inc. Email:

Yes

Orig Lic. Date 06/01/1983

[email protected]

Capacity:

CCMU Tualatin

71

Other Service:

DayCare 7 Administrator: Mark Williams Facility Phone (541) 469-3111

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 469-5970 The Evangelical Lutheran Good Samaritan Operator: The Evangelical Lutheran Good Samaritan Email: [email protected] Owner:

Yes

Capacity:

CCMU Tualatin

87

Other Service: Administrator:

Chloe Propp

Facility Phone (541) 687-9211 Orig Lic. Date 01/17/1955 : Facility Fax: (541) 687-9687 Owner: The Evangelical Lutheran Good Samaritan Operator: The Evangelical Lutheran Good Samaritan

Medicaid Withdrawal: No

Yes 385133 Good Samaritan Society - Fairlawn Village 3457 NE Division Gresham, OR 97030 County: Multnomah Multnomah Co NF Unit

CCMU Tualatin

100

Administrator:

Medicaid Withdrawal: No

385147 Yes Good Samaritan Society - Eugene Village 3500 Hilyard St Eugene, OR 97405 County: Lane Eugene SSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385165 Yes Good Samaritan Society - Curry Village 1 Park Avenue-PO Box 1217 Brookings, OR 97415 County: Curry Gold Beach MSO Gold Beach MSO

[email protected]

Email:

Yes

Capacity:

[email protected] CCMU Tualatin

97

Other Service: Administrator:

Lorraine Westendorf

Facility Phone (503) 667-1965 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 667-1932 Owner: Evangelical Lutheran Good Sam. Society Operator: Evangelical Lutheran Good Sam. Society Email:

[email protected]

Page 9 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

38E188 No Gracelen Terrace Long Term Care Facility 10948 SE Boise St Portland, OR 97266 County: Multnomah Multnomah Co NF Unit

Yes

ADMINISTRATOR, PHONE Capacity:

Administrator:

Linda Glidden-Pickering

Facility Phone (503) 760-1727 : Facility Fax: (503) 762-2331 Owner: H & L Care Centers, Inc. Operator: H & L Care Centers, Inc.

Medicaid Withdrawal: No

Email:

385156 Yes Green Valley Rehabilitation Health Center 1735 Adkins St Eugene, OR 97401 County: Lane Eugene SSO

CCMU Tualatin

80

Other Service:

Yes

Orig Lic. Date 06/01/1983

[email protected]

Capacity:

CCMU Tualatin

110

Other Service: Administrator:

Loretta Botta

Facility Phone (541) 683-5032 : Facility Fax: (541) 683-5085 Owner: Green Valley L.L.C.

Orig Lic. Date 01/22/1969

Operator: Pinnacle Healthcare Management, Inc. Medicaid Withdrawal: No

385190 Gresham Rehab & Specialty Care 405 NE 5th St Gresham, OR 97030 County: Multnomah Multnomah Co NF Unit

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

CCMU Tualatin

88

Administrator:

Leslie Workman

Facility Phone (503) 666-5600 Orig Lic. Date 11/17/1993 : Facility Fax: (503) 667-9633 Owner: Pacific Regency Care LLC Operator: Gresham Rehab, LLC Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

40

Other Service: Administrator:

Cole Mack

Facility Phone (541) 382-0479 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 389-7054 Owner: Ohana Harmony House, LLC Operator: Ohana Harmony House, LLC

Medicaid Withdrawal: No

38E126 Healthcare at Foster Creek 6003 SE 136th Portland, OR 97236 County: Multnomah Multnomah Co NF Unit

Capacity:

Other Service:

Medicaid Withdrawal: No

385253 Harmony House Nursing Home 2366 NW Lakeside Place Bend, OR 97701 County: Deschutes Bend MSO

[email protected]

Email:

No

Yes

[email protected]

Capacity:

114

CCMU Tualatin

Other Service:

ECU 14 Administrator: Warren Taylor Facility Phone (503) 761-1155

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 761-1142 St. Jude Operating Company, LLC Operator: Benicia Senior Living, LLC Email: [email protected] Owner:

Page 10 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385091 Yes Hearthstone Nursing and Rehabilitation Center 2901 E Barnett Rd Medford, OR 97504 County: Jackson Medford SSO Medford DSO

Yes

Capacity:

DayCare 5 Administrator: Blake Epp Facility Phone (541) 779-4221

Orig Lic. Date 05/10/1968

: Facility Fax:

(541) 776-3423 Hearthstone Operator, LLC Operator: Pinnacle Healthcare Management, Inc. Email: [email protected] Owner:

Yes

Capacity:

CCMU Tualatin

174

Other Service: Administrator:

Jason Fiske

Facility Phone (541) 474-1901 : Facility Fax: (541) 471-8717 Owner: Highland House Inc.

Orig Lic. Date 01/22/1981

Operator: Pinnacle Healthcare Management, Inc.

Medicaid Withdrawal: No

Email:

385046 Yes Hillside Heights Rehabilitation Center 1201 McLean Blvd Eugene, OR 97405 County: Lane Eugene SSO

CCMU Tualatin

146

Other Service:

Medicaid Withdrawal: No

385149 Yes Highland House Nursing & Rehabilitation Center 2201 NW Highland Ave Grants Pass, OR 97526 County: Josephine Grants Pass MSO Grants Pass 1717

ADMINISTRATOR, PHONE

Yes

[email protected]

Capacity:

CCMU Tualatin

83

Other Service: Administrator:

Nathan Garber

Facility Phone (541) 683-2155 : Facility Fax: (541) 343-7289 Owner: Hillside Heights L.L.C.

Orig Lic. Date 02/17/1969

Operator: Pinnacle Healthcare Management, Inc. Medicaid Withdrawal: No

385259 Holladay Park Plaza 1300 NE 16th Ave Portland, OR 97232 County: Multnomah Multnomah Co NF Unit

Email:

Yes

No

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin

51

Other Service: Administrator:

Jeff Herinckx

Facility Phone (503) 288-6671 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 280-2455 Owner: Holladay Park Plaza, Inc. Operator: Pacific Retirement Services, Inc.

Medicaid Withdrawal: No

385104 Hood River Care Center 729 Henderson Rd Hood River, OR 97031 County: Hood River The Dalles MSO

[email protected]

Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin ACU 19, ECU 11 Administrator: John "Jack" C. Striker Facility Phone (541) 386-2688 Orig Lic. Date 06/01/1983 131

Other Service:

: Facility Fax:

(541) 386-1641 Care Center (Hood River) Inc., Operator: Prestige Care, Inc. Email: [email protected] Owner:

Page 11 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385188 Yes Independence Health and Rehabilitation Center 1525 Monmouth St Independence, OR 97351 County: Polk Dallas NWSDS Salem DSO

Yes

Capacity:

Administrator:

Operator: EmpRes Healthcare Management, LLC

Yes

[email protected]

Capacity:

CCMU Tualatin

95

Other Service: Administrator:

Theresa Heis

Orig Lic. Date 12/31/1971 Facility Phone (503) 370-8284 : Facility Fax: (503) 375-3535 Owner: Kindred Nursing Centers West, L.L.C. Operator: Kindred Nursing Centers West, L.L.C.

Medicaid Withdrawal: No

Email:

Yes

Craig Oltman

Facility Phone (503) 838-0001 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 838-7826 Owner: Evergreen Oregon Healthcare Independence L.L.C. Email:

385189 Yes Kindred Nursing and Rehabilitation-Sunnyside 4515 Sunnyside Rd SE Salem, OR 97302 County: Marion Salem NWSDS Salem DSO

CCMU Tualatin

80

Other Service:

Medicaid Withdrawal: No

385211 LaGrande Post Acute Rehab 91 Aries Lane La Grande, OR 97850 County: Union La Grande MSO

ADMINISTRATOR, PHONE

Yes

[email protected]

Capacity:

CCMU Tualatin DayCare 10 Administrator: Robert Mathieson Facility Phone (541) 963-8678 Orig Lic. Date 06/01/1983 76

Other Service:

: Facility Fax:

(541) 963-5024 Evergreen Oregon Healthcare Mt Vista, L.L.C. Operator: EmpRes Healthcare Management, LLC Email: [email protected] Owner:

Medicaid Withdrawal: No

385115 Yes Lake Dist Hosp & Long Term Care Facility 700 South J Lakeview, OR 97630 County: Lake Klamath Falls MSO

Yes

Capacity:

CCMU Tualatin

47

Other Service: Administrator:

Gordon Ensley

Facility Phone (541) 947-2114 : Facility Fax: (541) 947-2433 Owner: Lake Health District

Orig Lic. Date 06/01/1983

Operator: Lake Health District Medicaid Withdrawal: No

385232 Laurel Hill Nursing Center 859 NE Sixth St Grants Pass, OR 97526 County: Josephine Grants Pass MSO Grants Pass 1717 Medicaid Withdrawal: No

Wednesday, December 05, 2012

Email:

Yes

Yes

Capacity:

[email protected] CCMU Tualatin

44

Other Service: Administrator:

Don Atterberry

Facility Phone (541) 479-3700 : Facility Fax: (541) 471-2967 Owner: BD Grants Pass II, LLC

Orig Lic. Date 06/01/1983

Operator: Regency Pacific Management, LLC Email:

[email protected]

Page 12 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385010 Yes Laurelhurst Village Rehabilitation Center 3060 SE Stark St Portland, OR 97214 County: Multnomah Multnomah Co NF Unit

Yes

No

Capacity:

CCMU Tualatin

179

Other Service:

ALF 89 Administrator: Dane Jensen Facility Phone (503) 535-4700

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 797-6702 RSL Portland, LLC Operator: Radiant Senior Living, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

38E196 Lawrence Convalescent Center 812 SE 48th Ave Portland, OR 97215 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Yes

Capacity:

CCMU Tualatin

41

Other Service: Administrator:

Kelli Cannon

Facility Phone (503) 236-2624 : Facility Fax: (503) 233-9377 Owner: Charles Lawrence

Orig Lic. Date 06/01/1983

Operator: Charles Lawrence Medicaid Withdrawal: No

385157 Life Care Center Of Coos Bay 2890 Ocean Boulevard Coos Bay, OR 97420 County: Coos Coos Bay SSO

Email:

Yes

Yes

Administrator:

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Mardi Robers

Facility Phone (541) 267-5433 Orig Lic. Date 06/16/1975 : Facility Fax: (541) 267-6347 Owner: Life Care Centers Of America, Inc. Operator: Life Care Centers Of America, Inc. Email:

Yes

Yes

Capacity:

[email protected] CCMU Tualatin

110

Other Service: Administrator:

Sara Whitfield

Facility Phone (503) 472-4678 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 435-2203 Owner: McMinnville Medical Investors LP, Operator: Life Care Centers Of America, Inc.

Medicaid Withdrawal: No

385197 Linda Vista Nursing & Rehab Center 135 Maple St Ashland, OR 97520 County: Jackson Medford SSO Medford DSO

CCMU Tualatin

114

Other Service:

Medicaid Withdrawal: No

385171 Life Care Center Of McMinnville 1309 NE 27th St McMinnville, OR 97128 County: Yamhill McMinnville NWSDS McMinnville DSO

Capacity:

[email protected]

Email:

Yes

Yes

Capacity:

[email protected] CCMU Tualatin

87

Other Service: Administrator:

Brenda Thornton

Facility Phone (541) 482-2341 Orig Lic. Date 11/23/1970 : Facility Fax: (541) 482-4763 Owner: Care Center (Linda Vista) Inc. Operator: Prestige Care, Inc. Email:

[email protected]

Page 13 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385240 Marian Estates 390 Church St Sublimity, OR 97385 County: Marion Salem NWSDS Salem DSO

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

(503) 769-5037 Ernmaur, Inc. Operator: Marian Estates Support Services Email: [email protected] Owner:

No

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin

39

Other Service:

RCF 22, ACU 20 Administrator: Jaron Sue Facility Phone (503) 292-7874

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 292-2359 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Yes

Yes

Capacity:

106

CCMU Tualatin

Other Service:

ACU 22 Administrator: Nicole Easley Facility Phone (503) 665-3118

Orig Lic. Date 01/25/1968

: Facility Fax:

(503) 674-5759 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Yes

Yes

Capacity:

114

CCMU Tualatin

Other Service:

DayCare 8 Administrator: Deb Dooley Facility Phone (503) 357-7119

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 357-6122 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385260 Marquis Care at Hope Village 1577 S Ivy Canby, OR 97013 County: Clackamas Clackamas AAA

Orig Lic. Date 06/01/1983

: Facility Fax:

Medicaid Withdrawal: No

385204 Marquis Care at Forest Grove 3300 19th Avenue Forest Grove, OR 97116 County: Washington WCDAVS Beaverton DSO

CCMU Tualatin

214

ACU 51 Administrator: Denise Gould Facility Phone (503) 769-3499

Medicaid Withdrawal: No

385183 Marquis Care at Centennial 725 SE 202nd Ave Portland, OR 97233 County: Multnomah Multnomah Co NF Unit

Capacity:

Other Service:

Medicaid Withdrawal: No

38A026 Marquis Care at Autumn Hills 6630 SW Beav-Hillsdale Hwy Portland, OR 97225 County: Washington WCDAVS Beaverton DSO

ADMINISTRATOR, PHONE

Yes

Yes

Capacity:

50

CCMU Tualatin

Other Service:

ALF 84 Administrator: Patty Kleckner Facility Phone (503) 266-5541

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 266-5544 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Page 14 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385141 Marquis Care at Mt. Tabor 6040 SE Belmont Portland, OR 97215 County: Multnomah Multnomah Co NF Unit

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

[email protected]

Capacity:

CCMU Tualatin

67

Other Service: Administrator:

Ian Strand

Orig Lic. Date 12/19/1963 Facility Phone (503) 538-9436 : Facility Fax: (503) 538-7605 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

102

Other Service:

ACU 20 Administrator: Kylie Evenhus Facility Phone (503) 655-2588

Orig Lic. Date 07/01/1968

: Facility Fax:

(503) 655-8191 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

90

Other Service:

ALF 80 Administrator: Teresa Ohmart Facility Phone (503) 289-5571

Orig Lic. Date 12/19/1960

: Facility Fax:

(503) 289-6505 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385137 Marquis Care at Plum Ridge 1401 Bryant Williams Dr Klamath Falls, OR 97601 County: Klamath Klamath Falls MSO

Kym Wells

Facility Phone (503) 231-7166 Orig Lic. Date 03/01/1997 : Facility Fax: (503) 230-9858 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc.

Medicaid Withdrawal: No

385208 Marquis Care at Piedmont 319 NE Russet Portland, OR 97211 County: Multnomah Multnomah Co NF Unit

CCMU Tualatin

145

Administrator:

Medicaid Withdrawal: No

385221 Marquis Care at Oregon City 1680 Molalla Ave Oregon City, OR 97045 County: Clackamas Clackamas AAA

Capacity:

Other Service:

Medicaid Withdrawal: No

385180 Marquis Care at Newberg 1500 E First St Newberg, OR 97132 County: Yamhill McMinnville NWSDS McMinnville DSO

ADMINISTRATOR, PHONE

Yes

Yes

Capacity:

CCMU Tualatin

116

Other Service: Administrator:

Christine Prather

Facility Phone (541) 882-6691 Orig Lic. Date 11/15/1993 : Facility Fax: (541) 885-4515 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email:

[email protected]

Page 15 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385214 Marquis Care at Powellhurst 13033 SE Holgate Portland, OR 97236 County: Multnomah Multnomah Co NF Unit

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

[email protected]

Capacity:

CCMU Tualatin

52

Other Service: Administrator:

Brenda Wilson

Orig Lic. Date 06/01/1983 Facility Phone (503) 873-5362 : Facility Fax: (503) 873-3044 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

136

Other Service: Administrator:

Russ Kittrell

Facility Phone (541) 746-6581 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 744-0874 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

102

Other Service: Administrator:

Nicole Burnham

Facility Phone (503) 246-8811 Orig Lic. Date 12/28/1964 : Facility Fax: (503) 246-9557 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc.

Medicaid Withdrawal: No

385266 Marquis Care at Wilsonville 30900 SW Parkway Avenue Wilsonville, OR 97070 County: Clackamas Clackamas AAA

Jennifer Hagen

Facility Phone (503) 761-1533 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 761-2348 Owner: Marquis Companies I, Inc. Operator: Marquis Companies I, Inc.

Medicaid Withdrawal: No

385218 Marquis Care at Vermont Hills 6010 SW Shattuck Rd Portland, OR 97221 County: Multnomah Multnomah Co NF Unit

CCMU Tualatin

77

Administrator:

Medicaid Withdrawal: No

385077 Marquis Care at Springfield 1333 N First Springfield, OR 97477 County: Lane Eugene SSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385262 Marquis Care at Silver Gardens 115 S James St Silverton, OR 97381 County: Marion Woodburn NWSDS Salem DSO

ADMINISTRATOR, PHONE

Email:

Yes

Yes

[email protected]

Capacity:

50

CCMU Tualatin

Other Service:

ALF 72 Administrator: Theresa Decker Facility Phone (503) 682-2840

Orig Lic. Date 09/16/2002

: Facility Fax:

(503) 682-2869 Marquis Companies I, Inc. Operator: Marquis Companies I, Inc. Email: [email protected] Owner:

Page 16 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385265 Mary's Woods at Marylhurst 17360 Holy Names Drive Lake Oswego, OR 97034 County: Clackamas Clackamas AAA

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

(503) 534-3937 Mary's Woods at Marylhurst, Inc. Operator: Mary's Woods at Marylhurst, Inc. Email: [email protected] Owner:

Yes

Yes

CCMU Tualatin

155

ACU 20 Administrator: Kathleen Parry Facility Phone (503) 643-8626

Orig Lic. Date 05/20/1963

: Facility Fax:

(503) 520-1435 Sisters of St. Mary of Oregon Maryville Corp. Operator: Sisters of St. Mary of Oregon Maryville Corp. Email: [email protected] Owner:

Yes

Capacity:

Administrator:

Yes

Orig Lic. Date 06/01/1983

[email protected]

Capacity:

CCMU Tualatin

110

Other Service: Administrator:

Dane Reeves, Interim

Facility Phone (541) 779-3551 Orig Lic. Date 07/01/1962 : Facility Fax: (541) 779-3658 Owner: Kindred Nursing Centers West, L.L.C. Operator: Kindred Nursing Centers West, L.L.C.

Medicaid Withdrawal: No

Email:

Yes

Lael Hepworth

Facility Phone (503) 397-2713 : Facility Fax: (503) 397-2669 Owner: Extendicare Homes, Inc. Operator: Extendicare Homes, Inc. Email:

385024 Yes Medford Rehabilitation and Healthcare Center 625 Stevens St Medford, OR 97504 County: Jackson Medford MSO Medford DSO

CCMU Tualatin

92

Other Service:

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

Other Service:

385222 Yes Meadow Park Health & Specialty Care Center 75 Shore Drive St Helens, OR 97051 County: Columbia St Helens MSO

Medicaid Withdrawal: No

CCMU Tualatin ALF 72, DayCare 2 Administrator: Lynn Szender Facility Phone (503) 675-2475 Orig Lic. Date 02/07/2001 23

: Facility Fax:

Medicaid Withdrawal: No

385206 Mennonite Home 5353 Columbus Street Southeast Albany, OR 97322 County: Linn Albany SSO Albany DSO

Capacity:

Other Service:

Medicaid Withdrawal: 03/01/2007

385166 Maryville Nursing Home 14645 SW Farmington Rd Beaverton, OR 97007 County: Washington WCDAVS Beaverton DSO

ADMINISTRATOR, PHONE

Yes

[email protected]

Capacity:

CCMU Tualatin ALF 137, RCF 28 Administrator: Rob Hays Facility Phone (541) 928-5152 Orig Lic. Date 10/02/1953 95

Other Service:

: Facility Fax:

(541) 917-1358 Mennonite Home Of Albany, Inc. Operator: Mennonite Home Of Albany, Inc. Email: [email protected] Owner:

Page 17 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

ADMINISTRATOR, PHONE Capacity:

CCMU Tualatin

385161 Yes Yes Milton Freewater Health and Rehabilitation Center 120 Elzora St Milton-Freewater, OR 97862 County: Umatilla Pendleton MSO

129

Facility Phone (541) 938-3318 Orig Lic. Date 06/07/1965 : Facility Fax: (541) 938-4657 Owner: Evergreen Oregon Healthcare Orchards Rehabilitatio

Medicaid Withdrawal: No

Email:

Other Service: Administrator:

JoAnn Parker

Operator: EmpRes Healthcare Management, LLC

385270 Milwaukie Convalescent Center 12045 SE Stanley Ave. Milwaukie, OR 97222 County: Clackamas Clackamas AAA

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Bill Price

Orig Lic. Date 02/25/1963 Facility Phone (503) 659-2323 : Facility Fax: (503) 659-2766 Owner: Milwaukie Convalescent Hospital, Inc. Operator: Aidan Health Services, Inc. Email:

Yes

No

[email protected]

Capacity:

CCMU Tualatin ACU 17 Administrator: Sharon VanEaton Facility Phone (503) 901-2939 Orig Lic. Date 12/01/2010 44

Other Service:

: Facility Fax: Owner:

Mirabella at South Waterfront

Operator: Pacific Retirement Services, Inc. Email: [email protected]

Yes

Yes

Capacity:

CCMU Tualatin

92

Other Service:

ACU 14 Administrator: Robert S. Barry Facility Phone (503) 829-5591

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 829-9127 Care Center (Molalla) Inc. Operator: Prestige Care, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385254 Myrtle Point Care Center 637 Ash St Myrtle Point, OR 97458 County: Coos Coos Bay MSO

CCMU Tualatin

96

Administrator:

Medicaid Withdrawal: No

385150 Molalla Manor Care Center 301 Ridings Ave Molalla, OR 97038 County: Clackamas Clackamas AAA

Capacity:

Other Service:

Medicaid Withdrawal: No

38L400 Mirabella Portland 3550 SW Bond Ave. Portland, OR 97239 County: Multnomah Multnomah Co NF Unit

[email protected]

Yes

Yes

Capacity:

CCMU Tualatin

35

Other Service:

RCF 16 Administrator: Kent Emry Facility Phone (541) 572-2066

Orig Lic. Date 05/13/1970

: Facility Fax:

(541) 572-5477 Care Centers Management, Inc. Operator: Dakavia Management, Corp. Email: [email protected] Owner:

Page 18 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385244 Nehalem Valley Care Center PO Box 6, 280 Rowe St Wheeler, OR 97147 County: Tillamook Tillamook NWSDS Tillamook DSO

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

[email protected]

Capacity:

CCMU Tualatin

116

Other Service: Administrator:

Will Smith

Orig Lic. Date 02/05/1968 Facility Phone (503) 472-3141 : Facility Fax: (503) 472-9334 Owner: Northwest Country Place, Inc. Operator: Northwest Country Place, Inc. Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin ACU 17 Administrator: Karen W. Walker, Interim Facility Phone (541) 447-7667 Orig Lic. Date 04/21/1967 63

Other Service:

: Facility Fax:

(541) 447-6685 BD Prineville II, LLC Operator: Regency Pacific Management, LLC Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

53

Other Service: Administrator:

Scott Ferguson

Facility Phone (503) 656-4035 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 656-1089 Owner: Care Center (Oregon City) Inc. Operator: Prestige Care, Inc.

Medicaid Withdrawal: No

385257 Oregon Veterans' Home 700 Veterans Drive The Dalles, OR 97058 County: Wasco The Dalles

James Aldred

Facility Phone (503) 368-5171 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 368-5140 Owner: Wheeler Care Center, LLC Operator: Aidan Health Services, Inc.

Medicaid Withdrawal: No

385245 Oregon City Health Care Center 148 Hood St Oregon City, OR 97045 County: Clackamas Clackamas AAA

CCMU Tualatin

50

Administrator:

Medicaid Withdrawal: No

385261 Ochoco Care Center 950 NE Elm Street Prineville, OR 97754 County: Crook Bend MSO Prineville MSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385225 Oakwood Country Place 421 S Evans St McMinnville, OR 97128 County: Yamhill McMinnville NWSDS McMinnville DSO

ADMINISTRATOR, PHONE

Email:

Yes

Yes

[email protected]

Capacity:

151

CCMU Tualatin

Other Service:

ACU 25 Administrator: Cheryl Maitland Facility Phone (541) 296-7190

Orig Lic. Date 11/13/1997

: Facility Fax:

(541) 296-7862 Oregon Dept Of Veterans Affairs Operator: Veterans Care Centers of Oregon Email: [email protected] Owner:

Page 19 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385272 Pacific Health and Rehabilitation 14145 SW 105th St Tigard, OR 97224 County: Washington WCDAVS Beaverton DSO

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

Capacity:

CCMU Tualatin

112

Other Service: Administrator:

Catherine Lewis

Facility Phone (503) 639-1144 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 620-7201 Owner: Pacific Gardens Estates, LLC Operator: Dover Management, Inc.

Medicaid Withdrawal: No

385258 Park Forest Care Center 8643 NE Beech St Portland, OR 97220 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

55

Other Service: Administrator:

Eric Murk

Orig Lic. Date 06/01/1983 Facility Phone (503) 256-2151 : Facility Fax: (503) 256-2154 Owner: Care Center ( Park Forest) Inc. Operator: Prestige Care, Inc.

Medicaid Withdrawal: No

385271 Pearl at Kruse Way, The 4550 Carman Drive Lake Oswego, OR 97035 County: Clackamas Clackamas AAA

Email:

Yes

No

Capacity:

CCMU Tualatin

45

Other Service:

RCF 47 Administrator: Lisa Sienkiewicz Facility Phone (503) 675-6055

Orig Lic. Date 12/29/2005

: Facility Fax:

(503) 675-6077 Avamere Lake Oswego Operations Investors, LLC Operator: Avamere Lake Oswego Operations Investors, LLC Email: [email protected] Owner:

Medicaid Withdrawal: No

385138 Pilot Butte Rehabilitation Center 1876 NE Hwy 20 Bend, OR 97701 County: Deschutes Bend MSO

[email protected]

Yes

Yes

Capacity:

CCMU Tualatin

100

Other Service: Administrator:

Thomas Hathaway

Facility Phone (541) 382-5531 : Facility Fax: (541) 317-5573 Owner: BD Bend II, LLC

Orig Lic. Date 08/27/1973

Operator: Regency Pacific Management, LLC Medicaid Withdrawal: No

Yes 385273 Pioneer Nursing Home Health District 1060 D Street W Vale, OR 97918 County: Malheur Ontario MSO Medicaid Withdrawal: No

Wednesday, December 05, 2012

Email:

Yes

[email protected]

Capacity:

CCMU Tualatin ALF 30, DayCare 4 Administrator: David Looper Facility Phone (541) 473-3131 Orig Lic. Date 06/01/1983 33

Other Service:

: Facility Fax:

(541) 473-2842 Pioneer Nursing Home Health District Operator: Pioneer Nursing Home Health District Email: [email protected] Owner:

Page 20 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385045 Porthaven Healthcare Center 5330 NE Prescott Portland, OR 97218 County: Multnomah Multnomah Co NF Unit

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

Capacity:

CCMU Tualatin

99

Other Service:

DayCare 3 Administrator: Sarah Murk Facility Phone (503) 288-6585

Orig Lic. Date 05/15/1955

: Facility Fax:

(503) 288-0014 Care Center (Porthaven) Inc. Operator: Prestige Care, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385228 Yes Portland Health and Rehabilitation Center 12441 SE Stark St Portland, OR 97233 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Yes

Capacity:

CCMU Tualatin

105

Other Service: Administrator:

Matthew Hartley

Orig Lic. Date 06/01/1983 Facility Phone (503) 255-7040 : Facility Fax: (503) 255-0555 Owner: Evergreen Oregon Healthcare Portland, L.L.C. Operator: EmpRes Healthcare Management, LLC

Medicaid Withdrawal: No

385008 Yes Presbyterian Community Care Center 1085 N Oregon St Ontario, OR 97914 County: Malheur Ontario MSO

Email:

Yes

Capacity:

CCMU Tualatin DayCare 10 Administrator: Cathleen Sullivan Facility Phone (541) 889-9133 Orig Lic. Date 06/01/1983 96

Other Service:

: Facility Fax:

(541) 889-6436 Presbyterian Nursing Home, Inc. Operator: Presbyterian Nursing Home, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385044 Yes Prestige Care and Rehabilitation of Menlo Park 745 NE 122nd Ave Portland, OR 97230 County: Multnomah Multnomah Co NF Unit

[email protected]

Yes

Capacity:

CCMU Tualatin

83

Other Service: Administrator:

Mary Prentice

Facility Phone (503) 252-0241 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 257-9091 Owner: Care Center (Menlo Park) Inc. Operator: Prestige Care, Inc.

Medicaid Withdrawal: No

Yes 385055 Prestige Care and Rehabilitation of Reedwood 3540 SE Francis St Portland, OR 97202 County: Multnomah Multnomah Co NF Unit Medicaid Withdrawal: No

Wednesday, December 05, 2012

Email:

Yes

Capacity:

[email protected] CCMU Tualatin

64

Other Service: Administrator:

Glenn Bushong

Facility Phone (503) 232-5767 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 234-4162 Owner: Care Center (Reedwood) Inc. Operator: Prestige Care Inc. Email:

[email protected]

Page 21 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385018 Yes Providence Benedictine Nursing Center 540 South Main St Mt. Angel, OR 97362 County: Marion Woodburn NWSDS Salem DSO

Yes

No

(503) 845-9229 Providence Health & Services - Oregon Operator: Providence Health & Services - Oregon Email: [email protected] Owner:

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin

58

Other Service:

PED 58 Administrator: Patricia Budo Facility Phone (503) 215-2400

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 215-0660 Providence Health & Services - Oregon Operator: Providence Health & Services - Oregon Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

22

Other Service: Administrator:

Mary Lee

Facility Phone (503) 717-7000 Orig Lic. Date 07/08/1996 : Facility Fax: (503) 717-7505 Owner: Providence Health & Services - Oregon Operator: Providence Health & Services - Oregon Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

74

Other Service:

DayCare 7 Administrator: Scott Brooks Facility Phone (541) 548-5066

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 548-3752 BD Redmond IV, LLC Operator: Regency Pacific Management, LLC Email: [email protected] Owner:

Medicaid Withdrawal: No

385220 Regency Albany 805 19th St. SE Albany, OR 97322 County: Linn Albany SSO Albany DSO

Orig Lic. Date 06/01/1983

: Facility Fax:

Medicaid Withdrawal: No

385230 Redmond Health Care Center 3025 SW Reservoir Redmond, OR 97756 County: Deschutes Bend MSO

CCMU Tualatin

98

ALF 52, ECU 16 Administrator: Emily Dazey Facility Phone (503) 845-6841

Medicaid Withdrawal: No

385252 Providence Seaside Hospital 725 S Wahanna Rd Seaside, OR 97138 County: Clatsop Astoria NWSDS Seaside DSO

Capacity:

Other Service:

Medicaid Withdrawal: No

38A001 Providence Child Center 830 NE 47th Ave Portland, OR 97213 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Yes

Yes

Capacity:

CCMU Tualatin

74

Other Service: Administrator:

William Scott

Facility Phone (541) 926-4741 : Facility Fax: (541) 926-6912 Owner: Regency Albany, LLC

Orig Lic. Date 06/01/1983

Operator: Regency Pacific Management, LLC Email:

[email protected]

Page 22 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385142 Regency Florence 1951 E 21St Street Florence, OR 97439 County: Lane Eugene SSO

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

(541) 997-4407 Regency Florence, LLC Operator: Regency Pacific Management, LLC Email: [email protected] Owner:

Medicaid Withdrawal: No

385263 Yes Yes Regency Hermiston Nursing & Rehabilitation Center 970 W Juniper Ave Hermiston, OR 97838 County: Umatilla Pendleton MSO Hermiston DSO Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin PED 12, DayCare 25 Administrator: Gailan Nichols Orig Lic. Date 06/01/1983 Facility Phone (503) 665-1151

Yes

Yes

128

Other Service:

: Facility Fax:

(503) 669-1986 Regency Gresham Nursing & Rehabilitation Center, L Operator: Regency Pacific Management, LLC Email: [email protected] Owner:

Capacity:

CCMU Tualatin

105

Other Service: Administrator:

Jerry Weldon

Facility Phone (541) 567-8337 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 567-0485 Owner: Regency Hermiston Nursing & Rehabilitation Center, Operator: Regency Pacific Management, LLC Email:

[email protected]

Capacity:

CCMU Tualatin ALF 159, RCF 36, ACU 17 Administrator: Kimberly Fuson Facility Phone (503) 535-4300 Orig Lic. Date 06/01/1983 88

Other Service:

: Facility Fax:

(503) 535-4330 Robison Jewish Home Operator: Robison Jewish Home Email: [email protected] Owner:

Medicaid Withdrawal: No

Medicaid Withdrawal: No

CCMU Tualatin ACU 22, DayCare 8 Administrator: Julie Piercy-Phelps Facility Phone (541) 997-8436 Orig Lic. Date 06/01/1983 72

: Facility Fax:

385015 Yes Yes Regency Gresham Nursing & Rehabilitation Center 5905 SE Powell Valley Rd Gresham, OR 97080 County: Multnomah Multnomah Co NF Unit

385250 Rogue Valley Manor 1200 Mira Mar Ave Medford, OR 97504 County: Jackson Medford SSO Medford DSO

Capacity:

Other Service:

Medicaid Withdrawal: No

385145 Robison Jewish Health Center 6125 SW Boundary Portland, OR 97221 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Yes

No

Capacity:

68

CCMU Tualatin

Other Service:

RCF 25 Administrator: Beth Nolan Facility Phone (541) 857-7029

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 857-7594 Rogue Valley Manor Operator: Pacific Retirement Services, Inc. Email: [email protected] Owner:

Page 23 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 38E157 Rose City Nursing Home 34 NE 20th Portland, OR 97232 County: Multnomah Multnomah Co NF Unit

LICENSED CAPACITY MEDICARE MEDICAID No

Yes

Harry Geistlinger

Facility Phone (503) 231-0276 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 238-8678 Owner: Geistlinger Enterprises, Inc. Operator: Geistlinger Enterprises, Inc. Email:

Yes

Yes

[email protected]

Capacity:

CCMU Tualatin

193

Other Service: Administrator:

Stacy Jones

Facility Phone (541) 672-1631 : Facility Fax: (541) 672-1563 Owner: Fisher Care, Inc.

Orig Lic. Date 06/01/1983

Operator: Pinnacle Healthcare Management, Inc. Email:

No

Yes

[email protected]

Capacity:

CCMU Tualatin

71

Other Service:

RCF 40 Administrator: Marcia Johnson Facility Phone (503) 655-0474

Orig Lic. Date 06/01/1983

: Facility Fax:

(503) 655-2850 West Linn Care Center Operating Company, LLC Operator: Benicia Senior Living, LLC Email: [email protected] Owner:

Medicaid Withdrawal: No

38L544 Rose Villa Senior Living 13505 SE River Rd Portland, OR 97222 County: Clackamas Clackamas AAA

CCMU Tualatin

30

Administrator:

Medicaid Withdrawal: No

38E018 Rose Linn Care Center 2330 Debok West Linn, OR 97068 County: Clackamas Clackamas AAA

Capacity:

Other Service:

Medicaid Withdrawal: No

385151 Rose Haven Nursing Center 740 NW Hill Place Roseburg, OR 97471 County: Douglas Roseburg AAA Roseburg DSO

ADMINISTRATOR, PHONE

No

No

CCMU Tualatin

45

Other Service: Administrator:

Erin Cornell

Facility Phone (503) 654-3171 : Facility Fax: (503) 652-3291 Owner: Rose Villa, Inc.

Orig Lic. Date 06/01/1983

Operator: Rose Villa, Inc. Email: [email protected]

Medicaid Withdrawal: No

Yes 385148 Royale Gardens Health & Rehabilitation Center 2075 NW Highland Ave Grants Pass, OR 97526 County: Josephine Grants Pass MSO

Capacity:

Yes

Capacity:

CCMU Tualatin

191

Other Service: Administrator:

Ben Garber

Facility Phone (541) 476-8891 : Facility Fax: (541) 476-2679 Owner: RGO, LLC

Orig Lic. Date 06/01/1983

Operator: Pinnacle Healthcare Management, Inc. Medicaid Withdrawal: No

Wednesday, December 05, 2012

Email:

[email protected]

Page 24 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS

LICENSED CAPACITY MEDICARE MEDICAID

385241 Yes Sherwood Park Nursing & Rehab Center 4062 Arleta Ave NE Keizer, OR 97303 County: Marion Salem NWSDS Salem DSO

Yes

Capacity:

Administrator:

Kandi Hanson

Facility Phone (503) 390-2271 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 390-0177 Owner: Sherwood Park Nursing Home, Inc. Operator: Sherwood Park Nursing Home, Inc. Email:

Yes

CCMU Tualatin

49

Other Service:

Medicaid Withdrawal: No

385167 South Hills Rehabilitation Center 1166 East 28th Ave Eugene, OR 97403 County: Lane Eugene SSO

ADMINISTRATOR, PHONE

Yes

[email protected]

Capacity:

CCMU Tualatin

110

Other Service:

PED 10 Administrator: Martha Jenness Facility Phone (541) 345-0534

Orig Lic. Date 11/22/1993

: Facility Fax:

(541) 343-0913 Garber Enterprises, Inc. Operator: Pinnacle Healthcare Management, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385172 Yes The Dalles Health and Rehabilitation Center 1023 W 25th The Dalles, OR 97058 County: Wasco The Dalles MSO

Yes

Capacity:

CCMU Tualatin

83

Other Service: Administrator:

Leann Curtis, Prov.

Facility Phone (541) 298-5158 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 298-3864 Owner: Evergreen Oregon Healthcare Valley Vista, L.L.C. Operator: EmpRes Healthcare Management, LLC

Medicaid Withdrawal: No

38E075 Tierra Rose Care Center 4254 Weathers St NE Salem, OR 97301 County: Marion Salem NWSDS Salem DSO

Email:

No

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin

76

Other Service:

RCF 50 Administrator: Lori Lassen Facility Phone (503) 585-4602

Orig Lic. Date 12/06/1993

: Facility Fax:

(503) 585-6002 CML, Inc. Operator: CML, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385107 Timberview Care Center 1023 6th Avenue Southwest Albany, OR 97321 County: Linn Albany SSO Albany DSO

[email protected]

Yes

Yes

Capacity:

CCMU Tualatin

97

Other Service: Administrator:

Anne Haddock

Facility Phone (541) 926-8664 : Facility Fax: (541) 926-0276 Owner: PCI Care Venture I, Inc.

Orig Lic. Date 12/15/1993

Operator: Prestige Care, Inc. Email:

[email protected]

Page 25 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 385236 Town Center Village Rehab 8607 SE Causey Ave Portland, OR 97086 County: Clackamas Clackamas AAA

LICENSED CAPACITY MEDICARE MEDICAID Yes

Yes

ADMINISTRATOR, PHONE Capacity:

CCMU Tualatin

51

Other Service: Administrator:

Krista Blecha-Mattox

Facility Phone (503) 654-4500 : Facility Fax: (503) 786-1232 Owner: TCV Senior Living, LLC

Orig Lic. Date 12/06/1993

Operator: Generations, LLC Medicaid Withdrawal: No

Email:

385264 Yes Trinity Mission Health & Rehab of Portland, LLC 10435 SE Cora Portland, OR 97266 County: Multnomah Multnomah Co NF Unit

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

[email protected]

Capacity:

CCMU Tualatin

90

Other Service:

DayCare 10 Administrator: Alan Romero Facility Phone (541) 523-8145

Orig Lic. Date 06/01/1983

: Facility Fax:

(541) 523-1794 Saint Alphonsus Medical Center - Baker City, Inc. Operator: Saint Alphonsus Medical Center - Baker City, Inc. Email: [email protected] Owner:

Yes

Capacity:

CCMU Tualatin

118

Other Service: Administrator:

Mark Henrikson

Facility Phone (541) 464-7100 Orig Lic. Date 01/01/1997 : Facility Fax: (541) 464-7101 Owner: Umpqua Valley Nursing & Rehabilitation Center, LLC Operator: Pinnacle Healthcare Management, Inc.

Medicaid Withdrawal: No

Email:

Yes

Janelle Bufford

Orig Lic. Date 06/01/1983 Facility Phone (503) 760-1737 : Facility Fax: (503) 761-1582 Owner: Trinity Mission Health & Rehab of Portland, LLC Operator: Trinity Mission Health & Rehab of Portland, LLC Email:

385143 Yes Umpqua Valley Nursing & Rehabilitation Center 525 W Umpqua St Roseburg, OR 97470 County: Douglas Roseburg AAA Roseburg DSO

CCMU Tualatin

53

Administrator:

Medicaid Withdrawal: No

385120 Valley West Health Care Center 2300 Warren St Eugene, OR 97405 County: Lane Eugene SSO

Capacity:

Other Service:

Medicaid Withdrawal: No

38A028 Trinity St. Elizabeth Health Services, Inc. 3325 Pocahontas Rd Baker City, OR 97814 County: Baker Baker City MSO

[email protected]

Yes

Capacity:

[email protected] CCMU Tualatin

121

Other Service: Administrator:

Anthony Knipper

Facility Phone (541) 686-2828 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 686-9093 Owner: Life Care Centers Of America, Inc. Operator: Life Care Centers Of America, Inc. Email:

[email protected]

Page 26 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS COUNTY, LOCAL UNITS 38L501 Village at Hillside 440 NW Hillside Parkway McMinnville, OR 97128 County: Yamhill McMinnville NWSDS

LICENSED CAPACITY MEDICARE MEDICAID Yes

No

CCMU Tualatin

20

ALF 60, RCF 20 Administrator: Sasha Hightower Facility Phone (503) 472-9534

Orig Lic. Date 05/16/2005

: Facility Fax:

(503) 883-7477 EmeriCare, Inc Operator: EmeriCare, Inc. Email: [email protected] Owner:

Yes

Yes

Capacity:

CCMU Tualatin

106

Other Service: Administrator:

Greg Madson

Orig Lic. Date 06/01/1983 Facility Phone (503) 665-0183 : Facility Fax: (503) 666-6609 Owner: Village Health Care I, LLC Operator: Village Health Care I, LLC

Medicaid Withdrawal: No

38E174 Village Manor 2060 NE 238th Drive Wood Village, OR 97060 County: Multnomah Multnomah Co NF Unit

Capacity:

Other Service:

Medicaid Withdrawal: No

385068 Village Health Care 3955 SE 182nd Ave Gresham, OR 97030 County: Multnomah Multnomah Co NF Unit

ADMINISTRATOR, PHONE

Email:

No

Yes

[email protected]

Capacity:

CCMU Tualatin

60

Other Service: Administrator:

Derek Salway

Facility Phone (503) 491-0553 : Facility Fax: (503) 618-8162 Owner: V.M.C., Inc.

Orig Lic. Date 07/30/1954

Operator: V.M.C., Inc. Medicaid Withdrawal: No

385177 Vista Specialty Care 103 Adams Ave La Grande, OR 97850 County: Union La Grande MSO

Email:

Yes

Yes

Medicaid Withdrawal: No

Wednesday, December 05, 2012

Capacity:

CCMU Tualatin ACU 47, ECU 10, DayCare 3 Administrator: Emily Laprelle Facility Phone (541) 963-4184 Orig Lic. Date 06/01/1983 78

Other Service:

: Facility Fax:

(541) 963-8548 Evergreen Oregon Healthcare Valley View, L.L.C. Operator: EmpRes Healthcare Management, LLC Email: [email protected] Owner:

Medicaid Withdrawal: No

38E156 Wallowa Valley Care Center 207 E. Park Street Enterprise, OR 97828 County: Wallowa Enterprise MSO

[email protected]

No

Yes

Capacity:

CCMU Tualatin

32

Other Service: Administrator:

David Harman

Facility Phone (541) 426-5311 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 426-1903 Owner: Wallowa County Health Care District Operator: Wallowa County Health Care District Email:

[email protected]

Page 27 of 28

Seniors and People with Disabilities Licensed Nursing Facilities FACILITY, ADDRESS

LICENSED CAPACITY

COUNTY, LOCAL UNITS

MEDICARE MEDICAID

385112 Yes West Hills Health & Rehabilitation Center 5701 SW Multnomah Blvd Portland, OR 97219 County: Multnomah Multnomah Co NF Unit

Yes

ADMINISTRATOR, PHONE Capacity:

Administrator:

Email:

Yes

No

shaskins@westhillshealth&rehab.com

Capacity:

CCMU Tualatin

6

Other Service:

ALF 45, RCF 21 Administrator: Daren Bucklin Facility Phone (503) 353-7000

Orig Lic. Date 03/19/2001

: Facility Fax:

(503) 652-6255 Willamette View, Inc. dba Operator: Willamette View, Inc. Email: [email protected] Owner:

Medicaid Withdrawal: No

385201 Willowbrook Terrace 707 SW 37th Street Pendleton, OR 97801 County: Umatilla Pendleton MSO

Sandra Haskins

Facility Phone (503) 244-1107 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 244-8881 Owner: West Hills Convalescent Center Limited Partnership Operator: West Hills Convalescent Center Limited Partnership

Medicaid Withdrawal: No

385200 Willamette View Health Center 13145 SE River Rd Milwaukie, OR 97222 County: Clackamas Clackamas AAA

CCMU Tualatin

180

Other Service:

Yes

Yes

Capacity:

CCMU Tualatin

84

Other Service: Administrator:

Steve E. Hamilton

Facility Phone (541) 276-3374 Orig Lic. Date 06/01/1983 : Facility Fax: (541) 276-5326 Owner: Care Center (Willowbrook), Inc. Operator: Prestige Care, Inc.

Medicaid Withdrawal: No

Email:

385224 Yes Windsor Health and Rehabilitation Center 820 Cottage St NE Salem, OR 97301 County: Marion Salem NWSDS Salem DSO Medicaid Withdrawal: No

Total Number of NF's:

Wednesday, December 05, 2012

Yes

Capacity:

CCMU Tualatin

100

Other Service: Administrator:

Theresa Heis

Facility Phone (503) 399-1135 Orig Lic. Date 06/01/1983 : Facility Fax: (503) 399-7273 Owner: Evergreen Oregon Healthcare Salem L.L.C. Operator: EmpRes Healthcare Management, LLC Email:

139

[email protected]

[email protected]

Statewide Licensed Capacity:

12,154

Page 28 of 28