Inspection Reports for
Salem Transitional Care
3445 Boone Rd SE, Salem, OR 97317, Salem, OR, 97317
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
18.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
173% worse than Oregon average
Oregon average: 6.7 deficiencies/yearDeficiencies per year
28
21
14
7
0
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 2
Date: Jul 8, 2025
Visit Reason
Two initial comment citations were issued with no deficiencies corrected at the time of visit.
Findings
Two initial comment citations were issued with no deficiencies corrected at the time of visit.
Deficiencies (2)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 15
Date: Apr 15, 2025
Visit Reason
Multiple deficiencies related to failure to honor resident preferences, abuse prevention, notification of discharge, medication administration, pressure ulcer care, accident hazards, catheter care, staff performance reviews, pharmaceutical services, and medication error prevention. Many deficiencies were not corrected on revisit.
Findings
Multiple deficiencies related to failure to honor resident preferences, abuse prevention, notification of discharge, medication administration, pressure ulcer care, accident hazards, catheter care, staff performance reviews, pharmaceutical services, and medication error prevention. Many deficiencies were not corrected on revisit.
Deficiencies (15)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0561 - Self-Determination: Facility failed to honor resident preference for medication administration placing residents at risk for loss of autonomy.
F0600 - Free from Abuse and Neglect: Facility failed to honor resident choice for medication administration placing residents at risk for choking.
F0623 - Notice Requirements Before Transfer/Discharge: Facility failed to notify State Long-Term Care Ombudsman of resident transfers/discharges placing residents at risk for lack of notification.
F0625 - Notice of Bed Hold Policy Before/Upon Trnsfr: Facility failed to provide bed hold policy notification to resident representative placing residents at risk for lack of knowledge of return rights.
F0658 - Services Provided Meet Professional Standards: Facility staff failed to follow professional standards for medication administration placing residents at risk for unsafe medication administration.
F0686 - Treatment/Svcs to Prevent/Heal Pressure Ulcer: Facility failed to monitor and update care plans for pressure injuries placing residents at risk for worsening pressure injuries.
F0689 - Free of Accident Hazards/Supervision/Devices: Facility failed to ensure safe application of heat pack resulting in resident burns.
F0690 - Bowel/Bladder Incontinence, Catheter, UTI: Facility failed to provide adequate catheter care placing residents at risk for unmet catheter needs.
F0730 - Nurse Aide Peform Review-12 hr/yr In-Service: Facility failed to ensure annual performance reviews for CNA staff placing residents at risk due to lack of competent staff.
F0755 - Pharmacy Srvcs/Procedures/Pharmacist/Records: Facility failed to provide timely pharmaceutical services placing residents at risk for lack of treatment.
F0760 - Residents are Free of Significant Med Errors: Facility failed to ensure proper administration of ibuprofen contributing to resident intestinal bleed and hospitalization.
F0947 - Required In-Service Training for Nurse Aides: Facility failed to ensure CNA staff received required annual in-service training placing residents at risk for care by incompetent staff.
F9999 - FINAL OBSERVATIONS: Final observations noted with no correction at time of visit.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 2
Date: Jan 27, 2025
Visit Reason
Two initial comment citations issued with no deficiencies corrected at time of visit.
Findings
Two initial comment citations issued with no deficiencies corrected at time of visit.
Deficiencies (2)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 6
Date: Oct 17, 2024
Visit Reason
Deficiencies related to resident dignity, professional standards, staffing, and administrative rules. Some deficiencies corrected on revisit, others not corrected.
Findings
Deficiencies related to resident dignity, professional standards, staffing, and administrative rules. Some deficiencies corrected on revisit, others not corrected.
Deficiencies (6)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0550 - Resident Rights/Exercise of Rights: Facility failed to ensure residents were treated with dignity placing residents at risk for lessened quality of life.
F0658 - Services Provided Meet Professional Standards: Facility failed to ensure nurse adhered to professional standards regarding dignity and plan of care placing residents at risk for abuse and undignified treatment.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
M0183 - Nursing Services: Minimum CNA Staffing: Facility failed to maintain minimum CNA staffing ratios placing residents at risk for delayed care.
M9999 - STATE OF OREGON ADMINISTRATIVE RULES: Refer to cited deficiencies for details.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 5
Date: May 17, 2024
Visit Reason
Deficiencies related to failure to report verbal abuse timely, failure to investigate abuse allegations thoroughly, and final observations. Some corrections made on revisit, others not corrected.
Findings
Deficiencies related to failure to report verbal abuse timely, failure to investigate abuse allegations thoroughly, and final observations. Some corrections made on revisit, others not corrected.
Deficiencies (5)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0609 - Reporting of Alleged Violations: Facility failed to report verbal abuse allegation to State Survey Agency within required two hours placing residents at risk for ongoing abuse.
F0610 - Investigate/Prevent/Correct Alleged Violation: Facility failed to thoroughly investigate verbal abuse allegation placing residents at risk for ongoing abuse.
F9999 - FINAL OBSERVATIONS: Final observations noted with no correction at time of visit.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 4
Date: Feb 16, 2024
Visit Reason
Deficiencies related to pressure ulcer care, accident prevention, staffing, medication storage, and administrative rules. Some deficiencies corrected on revisit, others not corrected.
Findings
Deficiencies related to pressure ulcer care, accident prevention, staffing, medication storage, and administrative rules. Some deficiencies corrected on revisit, others not corrected.
Deficiencies (4)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0686 - Treatment/Svcs to Prevent/Heal Pressure Ulcer: Facility failed to assess and monitor pressure ulcers resulting in Stage 4 ulcers requiring hospitalization.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
M9999 - STATE OF OREGON ADMINISTRATIVE RULES: Refer to cited deficiencies for details.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 10
Date: Jan 12, 2024
Visit Reason
Deficiencies related to care planning, professional standards, hearing and vision treatment, accident prevention, pain management, medication storage, and staffing. Some deficiencies corrected on revisit, others not corrected.
Findings
Deficiencies related to care planning, professional standards, hearing and vision treatment, accident prevention, pain management, medication storage, and staffing. Some deficiencies corrected on revisit, others not corrected.
Deficiencies (10)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0656 - Develop/Implement Comprehensive Care Plan: Facility failed to develop comprehensive care plan for hearing loss placing residents at risk for communication difficulties.
F0658 - Services Provided Meet Professional Standards: Facility failed to ensure professional standards for pain medication administration placing residents at risk for pain.
F0685 - Treatment/Devices to Maintain Hearing/Vision: Facility failed to assist with hearing device placing residents at risk for social isolation.
F0689 - Free of Accident Hazards/Supervision/Devices: Facility failed to implement care planned interventions for falls placing residents at risk for injury.
F0697 - Pain Management: Facility failed to ensure residents received pain medication as ordered placing residents at risk for increased pain.
F0761 - Label/Store Drugs and Biologicals: Facility failed to maintain proper medication storage temperatures and labeling placing residents at risk for reduced medication efficacy.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
M0182 - Nursing Services:Minimum Licensed Nurse Staff: Facility failed to ensure RN charge nurse coverage placing residents at risk for lack of nursing assessments.
M9999 - STATE OF OREGON ADMINISTRATIVE RULES: Refer to cited deficiencies for details.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 4
Date: Sep 12, 2023
Visit Reason
Deficiencies related to rehabilitation services and administrative rules. Some deficiencies corrected on revisit, others not corrected.
Findings
Deficiencies related to rehabilitation services and administrative rules. Some deficiencies corrected on revisit, others not corrected.
Deficiencies (4)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0825 - Provide/Obtain Specialized Rehab Services: Facility failed to provide rehabilitation services placing residents at risk for declined mobility.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
M9999 - STATE OF OREGON ADMINISTRATIVE RULES: Refer to cited deficiencies for details.
Inspection Report
Capacity: 80
Deficiencies: 3
Date: Jun 7, 2023
Visit Reason
Initial comments issued with no deficiencies corrected at time of visit.
Findings
Initial comments issued with no deficiencies corrected at time of visit.
Deficiencies (3)
E0000 - Initial Comments: Initial comments noted with no correction at time of visit.
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
Inspection Report
Complaint Investigation
Capacity: 80
Deficiencies: 4
Date: Jan 6, 2023
Visit Reason
Deficiencies related to care planning and accident prevention. Some deficiencies corrected on revisit, others not corrected.
Findings
Deficiencies related to care planning and accident prevention. Some deficiencies corrected on revisit, others not corrected.
Deficiencies (4)
F0000 - INITIAL COMMENTS: Initial comments noted with no correction at time of visit.
F0656 - Develop/Implement Comprehensive Care Plan: Facility failed to ensure care plan interventions were implemented placing residents at risk for falls and injury.
M0000 - Initial Comments: Initial comments noted with no correction at time of visit.
M9999 - STATE OF OREGON ADMINISTRATIVE RULES: Refer to cited deficiencies for details.
Loading inspection reports...
