Tierra Rose Care Center
Nursing Home, Assisted Living, Memory Care & Residential Care · Salem, OR
CMS overall rating
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Tierra Rose Care Center
Nursing Home, Assisted Living, Memory Care & Residential Care · Salem, OR
CMS overall rating
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Overview of Tierra Rose Care Center
Tierra Rose Care Center is a 76-bed nonprofit skilled nursing and memory care facility at 4254 Weathers Street NE, Salem, Marion County, Oregon. Operated by CML, Inc., the community provides rehabilitation, memory care, and 24-hour staffing with private and semi-private rooms, a park-like setting with fountains and walking paths, private dining rooms, and a beauty/barber shop. CMS rates the facility 2/5 overall, 2/5 Health Inspection, 4/5 Staffing, and 2/5 Quality Measures. Nursing hours averaged 17 percent above the Oregon state benchmark.
The regulatory trajectory documents severe historical challenges followed by substantial recent recovery. Over five years, Tierra Rose logged 94 deficiencies; 18.8 annually, 181 percent above Oregon’s 6.7-deficiency benchmark.
March 28, 2022, marked a critical inflection: a complaint investigation and relicensure survey documented thirty-two deficiencies spanning resident rights, timely assessment, care planning, wound care, medication management, infection control, staffing, training, quality assurance, and resident safety. Immediate jeopardy findings for elopement and aspiration risk were identified and abated. January 11, 2023, revealed twenty-two deficiencies in resident rights, safe environment, abuse and neglect prevention, assessment accuracy, wound care, medication management, staffing, training, infection control, and quality assurance; many were corrected, others persisted. April 21, 2023, cited sixteen deficiencies in reasonable accommodations, comprehensive care planning, quality of care, nursing staffing, medication regimen review, fall prevention, physician visits, and specialized rehabilitation; several were corrected, some remained.
June 28, 2024, documented nine deficiencies in foot care, accident hazards, medication storage, food sanitation, records accuracy, equipment maintenance, and restorative services; mixed correction status. October 17, 2025, identified five deficiencies in pressure ulcer treatment, infection prevention, and medication storage and labeling, all corrected by November 10, 2025. Inspections on November 13, 2025, April 16, 2025, and December 20, 2024, found zero deficiencies.
The dramatic shift from thirty-two deficiencies in March 2022 to zero citations in November 2025 indicates major operational restructuring and sustained improvement; however, the severity and breadth of the 2022–2024 violations counsel verification of present-day systems during tour.
The facility provides rehabilitation, memory care, and 24-hour skilled nursing with above-average staffing. Nonprofit ownership structure serves Salem with park-like grounds and amenities. Private pay is required; Medicaid and Medicare are not accepted.
The facility’s recent zero-deficiency trajectory is encouraging.
Families should ask about the corrective actions and operational changes implemented following the March 2022 immediate jeopardy findings and subsequent 2023 violations.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing hours breakdown
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Total nursing care / resident
This home is ranked 32nd out of 97 homes in Oregon for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
This home is ranked 32nd out of 97 homes in Oregon for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
5h 23m per day
Rank #32 / 97Nurse hours — State benchmarkedThis home is ranked 32nd out of 97 homes in Oregon. Shows adjusted nurse hours per resident per day benchmarked to the Oregon average, with a ranking across 97 Oregon facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Rankings are based only on facilities in Oregon that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs Oregon avg
+3%
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 4h 31m per day | ■ Avg State avg: 4h 32m per day · National avg: 3h 27m per day |
76-bed community Rank #121 / 351Bed count — State benchmarkedThis home is ranked 121st out of 351 homes in Oregon. Shows this facility's certified or reported bed count compared to other Oregon facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Rankings are based only on facilities in Oregon that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A larger shared setting that may offer more common spaces and organized community services.
32 years in operation Rank #59 / 374Years in operation — State benchmarkedThis home is ranked 59th out of 374 homes in Oregon. Shows how long this facility has been in operation compared to other Oregon facilities. Longer operating histories may benefit residents, families, and staff.Rankings are based only on facilities in Oregon that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
Walk Score: 50 / 100 Rank #289 / 476Walk Score — State benchmarkedThis home is ranked 289th out of 476 homes in Oregon. Shows how walkable this facility's neighborhood is compared to the average Walk Score across Oregon facilities. Higher scores benefit residents, families, and staff.Rankings are based only on facilities in Oregon that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
About this community
Facility TypeNf Only
StatusActive
IssuanceDecember 6, 1993
CountyMarion
Tierra Rose Care Center is administered by Colleen Rees.
Owner NameCml, Inc
Rehabilitation Services
Doctor on Staff
24-Hour Staffing
Intermediate Care (Nursing) Facility
Email
[email protected]
Fax(503) 585-7304
Beautifully Decorated And Spacious Building
Private And Semi-Private Rooms
Cable Tv In Common Areas
Park-Like Setting With Fountains
Pond
And Walking Paths
Private Dining Rooms For Family Events
Beauty/Barber Shop
Food DescriptionThree meals a day provided.
Inspection History
In Oregon, the Department of Human Services, Aging and People with Disabilities performs unannounced surveys and regular inspections to ensure resident safety in all care settings.
Since 2021 · 5 years of data
73 deficiencies
10 inspections
Inspection Scorecard
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Oregon state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Since 2021 vs. Oregon state average
Overall vs. OR average
4 Worse
Metrics worse than Oregon average:
• Total deficiencies (135% above)
• Deficiencies per year (135% above)
• Deficiencies per inspection (66% above)
• Total inspections (43% above) 0 Better No metrics in this bucket.
• Total deficiencies (135% above)
• Deficiencies per year (135% above)
• Deficiencies per inspection (66% above)
• Total inspections (43% above) 0 Better No metrics in this bucket.
Latest Inspection
November 13, 2025
Deficiencies
| This Facility | OR Average | vs. OR Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 73 | 31 | This facility has 135% more total deficiencies than a typical Oregon nursing home (73 vs. OR avg 31).↑ 135% worse |
|
Deficiencies per year
Average deficiencies per year since 2021.
| 14.6 | 6.2 | This facility has 135% more deficiencies per year than a typical Oregon nursing home (14.6 vs. OR avg 6.2).↑ 135% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 7.3 | 4.4 | This facility has 66% more deficiencies per inspection than a typical Oregon nursing home (7.3 vs. OR avg 4.4).↑ 66% worse |
Inspections
| This Facility | OR Average | vs. OR Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 10 | 7 | This facility has 43% more total inspections than a typical Oregon nursing home (10 vs. OR avg 7).↑ 43% worse |
Inspection Reports Summary
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
- The most recent inspection on November 13, 2025 found no deficiencies during the complaint and re-licensure survey.
- The October 17, 2025 inspection cited five deficiencies including pressure ulcer treatment, infection control, and medication storage, all corrected by November 10, 2025.
- The facility had multiple prior inspections with numerous deficiencies in care planning, staffing, medication management, and resident safety, including immediate jeopardy findings in March 2022.
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
Places of interest near Tierra Rose Care Center
2.0 miles from city center
Estimated distance in miles from Salem's city center to Tierra Rose Care Center's address, calculated via Google Maps.
Calculate Travel Distance to Tierra Rose Care Center
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The information below is reported by the Oregon Department of Human Services, Aging and People with Disabilities.
| Avamere Court at Keizer | NH AL IL RC | Keizer | 69
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OR AVG
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77.1%
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#20 / 95 | +17% | 4.47
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4.47
OR AVG
5.24
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#85 / 97 | -56% | -15% | $0
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$0
OR AVG
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#1 / 98 | 18
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18
OR AVG
34.0
Rank
#18 / 95 | 6.0
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6.0
OR AVG
6.9
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#44 / 95 | - | 52 | - |
76
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76
OR AVG
55
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#110 / 476 | Ari Cbc LLC | $12.9M
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$12.9M
OR AVG
$12.6M
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#36 / 93 | $6.3M
Facility
$6.3M
OR AVG
$4.5M
Rank
#31 / 93 | 48.8%
Facility
48.8%
OR AVG
38%
Rank
#48 / 93 | 385233 | ||||
| Salem Transitional Care | NH | Salem | 80
Facility
80
OR AVG
67
Rank
#106 / 351 |
71.0%
Facility
71.0%
OR AVG
65.7%
Rank
#33 / 95 | +8% | 5.00
Facility
5.00
OR AVG
5.24
Rank
#61 / 97 | -15% | -5% | $22.5k
Facility
$22.5k
OR AVG
$62.3k
Rank
#64 / 98 | 29
Facility
29
OR AVG
34.0
Rank
#39 / 95 | 3.6
Facility
3.6
OR AVG
6.9
Rank
#8 / 95 | 2 | 64 | - |
77
Facility
77
OR AVG
55
Rank
#105 / 476 | Tyler Bolin | $14.4M
Facility
$14.4M
OR AVG
$12.6M
Rank
#18 / 93 | $5.9M
Facility
$5.9M
OR AVG
$4.5M
Rank
#35 / 93 | 40.5%
Facility
40.5%
OR AVG
38%
Rank
#90 / 93 | 385234 | ||||
| Avamere Transitional Care at Sunnyside | NH RC | Salem (Morningside) | 88
Facility
88
OR AVG
67
Rank
#81 / 351 |
71.2%
Facility
71.2%
OR AVG
65.7%
Rank
#32 / 95 | +8% | 6.05
Facility
6.05
OR AVG
5.24
Rank
#11 / 97 | -47% | +15% | $0
Facility
$0
OR AVG
$62.3k
Rank
#1 / 98 | 53
Facility
53
OR AVG
34.0
Rank
#81 / 95 | 7.6
Facility
7.6
OR AVG
6.9
Rank
#61 / 95 | - | 77 | - |
78
Facility
78
OR AVG
55
Rank
#98 / 476 | Amanda Ingraham | $12.1M
Facility
$12.1M
OR AVG
$12.6M
Rank
#41 / 93 | $5.6M
Facility
$5.6M
OR AVG
$4.5M
Rank
#40 / 93 | 46.6%
Facility
46.6%
OR AVG
38%
Rank
#49 / 93 | 385189 | ||||
| Windsor Health and Rehabilitation | NH RC | Salem | 108
Facility
108
OR AVG
67
Rank
#41 / 351 | 86.3% | +3% | 3.86 | -46% | -3% | $19.4k | 42 | 10.5 | 2 | 97 | - |
85
Facility
85
OR AVG
55
Rank
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Financial Assistance for
Nursing Home in Oregon
Tierra Rose Care Center is located in Salem, Oregon.
Here are the financial assistance programs available to residents in Oregon.
Frequently Asked Questions about Tierra Rose Care Center
Who is the owner of Tierra Rose Care Center?
The legal owner and operator of Tierra Rose Care Center is Cml, Inc..
Is Tierra Rose Care Center in a walkable area?
Tierra Rose Care Center has a walk score of 50. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
What is the best email address for Tierra Rose Care Center?
The team at Tierra Rose Care Center can be reached at [email protected].
Who is the administrator of Tierra Rose Care Center?
Colleen Rees is the administrator of Tierra Rose Care Center.
How many beds does Tierra Rose Care Center have?
Tierra Rose Care Center has 76 beds.
Has Tierra Rose Care Center had any recent deficiencies or citations?
Tierra Rose Care Center has had 73 recently reported deficiencies.
Are there photos of Tierra Rose Care Center?
Yes — there are 4 photos of Tierra Rose Care Center in the photo gallery on this page.
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