01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-09-05 | 3 | 2025-09-05 | 1 |
| Cycle 2 | 2024-06-13 | 2 | 2024-06-13 | 2 |
| Cycle 3 | 2023-03-13 | 13 | 2023-03-13 | 5 |
CMS CCN 3852592026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Holladay Park Plaza
1300 Ne 16Th Avenue · Portland, OR 97232 · Multnomah County
Certified beds51CMS provider file
Recent citation rows26current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
26 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-30 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has plan of correction · 2026-07-31 · complaint2025-09-05 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-10-102025-09-05 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-10-102025-09-05 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2025-10-102024-06-13 · HEALTHF0625Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify 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.
Correction field: Deficient, Provider has date of correction · 2024-07-242024-06-13 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-07-242024-06-13 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-07-242024-06-13 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-07-242023-03-13 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0585Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0679Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0742Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · FIREK0211Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · FIREK0355Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2023-04-262023-03-13 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2023-04-2603 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HAWKINS, RICHARDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/01/2024
- JENSEN, CHRISIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/18/2023
- JOHNSON, LYNNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/18/2017
- MCLAUGHLIN, KATHLEENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/17/2018
- JOHNSON, LYNNIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/01/2022
- MCLAUGHLIN, KATHLEENIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/01/2023
- PLATTE, SUSANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/18/2016
- KALIN, LEAHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
- KIERNAN, JANETIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/16/2023
- PLATTE, SUSANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/18/2016
- SABATINI, ANTHONYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/28/2025
- SAMUELSON, KATELYNNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/21/2019
- PACIFIC RETIREMENT SERVICES INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 05/28/2025
- KALIN, LEAHIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- KIERNAN, JANETIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/16/2023
- PLATTE, SUSANIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/18/2016
- SABATINI, ANTHONYIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/17/2024
- SAMUELSON, KATELYNNIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/28/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.00per resident day
RN hours0.99per resident day
Weekend nurse hours4.65per resident day
Staff turnover32.7%CMS reported field
06 / LOCAL RECORDS
Open the Portland ledger →Other published facilities nearby
Avalon Care Center - Portland40 beds · CMS overall 3/545 citation rowsAvamere Crestview Of Portland127 beds · CMS overall 4/560 citation rowsBelmont Care And Rehabilitation41 beds · CMS overall 1/560 citation rowsCascade Terrace Post Acute105 beds · CMS overall 1/564 citation rowsCedar Crossings89 beds · CMS overall 3/588 citation rowsEvergreen Post Acute55 beds · CMS overall 2/553 citation rowsFernhill Rehabilitation And Care63 beds · CMS overall 2/574 citation rowsFernwood Supportive Living At Madrona Grove16 beds · CMS overall 4/532 citation rows