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Complaint Investigation

Laurelhurst Post Acute & Rehabilitation

Inspection Date: November 4, 2025
Total Violations 2
Facility ID 385010
Location PORTLAND, OR
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Inspection Findings

F-Tag F0684

Quality of Life and Care Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0684

involving Resident 303 occurred. Staff 2 stated it was her expectation Resident 303's needs and preferences were honored.

Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/04/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Laurelhurst Post Acute & Rehabilitation

3060 SE Stark Street Portland, OR 97214

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

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F-Tag F0692

Quality of Life and Care Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

10/24/25 but was not approved until 10/27/25.On 10/30/25 at 9:40 AM Staff 23 (Dietary Manager) stated

she was responsible for ordering Medpass 2.0 and confirmed there was a delay in administrative approval for the order she submitted on 10/24/25. She stated this delay resulted in the supplement being unavailable for Resident 305 on 10/25/25, 10/26/25 and 10/27/27.On 10/31/25 at 10:29 AM Staff 27 (LPN) stated the Medpass 2.0 supplement was unavailable just about every day since the transition of ownership. Staff 27 stated she checked throughout the facility to locate a supply, but it is usually not available. On 11/3/25 at 2:02 PM Staff 2 (DNS) stated the 9 notation on the MAR indicated the Medpass 2.0 supplement was not available. Staff 2 confirmed Resident 305 did not receive Medpass 2.0 as ordered on 10/25/25, 10/26/25 and 10/27/25.4. Resident 308 was admitted to the facility in 9/2014 with diagnoses including dysphagia (difficulty swallowing) and hemiplegia (loss of motor function on one side of the body).A physician order from 8/15/23 included 118 ml of Medpass 2.0, a nutritional supplement, to be provided to Resident 308 three times a day between meals.A 10/1/15 cognitive assessment determined Resident 308 had normal cognitive function.Review of the 10/2025 MAR revealed 9, which indicated the medication was unavailable, was entered on 10/24/25, 10/25/25, 10/26/25 and 10/27/25 for Medpass 2.0.On 10/30/25 at 9:40 AM Staff 23 (Dietary Manager) stated she was responsible for ordering Medpass 2.0 and confirmed there was a delay in administrative approval for the order she submitted on 10/24/25. She stated this delay resulted in

the supplement being unavailable for Resident 305 on 10/24/25, 10/25/25, 10/26/25 and 10/27/27.On 10/31/25 at 10:29 AM Staff 27 (LPN) stated the Medpass 2.0 supplement was unavailable just about every day since the transition of ownership. Staff 27 stated she checked throughout the facility to locate a supply, but it is usually not available. On 11/3/25 at 1:53 PM Resident 308 stated she/he did not recall receiving a nutritional supplement on 10/24/25, 10/25/25, 10/26/25 and 10/27/25.On 11/3/25 at 2:02 PM Staff 2 (DNS) stated the 9 notation on the MAR indicated the Medpass 2.0 supplement was not available. Staff 2 confirmed Resident 308 did not receive Medpass 2.0 as ordered on 10/24/25, 10/25/25, 10/26/25 and 10/27/25.

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📋 Inspection Summary

LAURELHURST POST ACUTE & REHABILITATION in PORTLAND, OR inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in PORTLAND, OR, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from LAURELHURST POST ACUTE & REHABILITATION or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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