Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Regency Gresham Nursing & Rehabilitation Center during CMS and state inspections, most recent first.
The facility did not ensure residents were aware of their right to review survey results, nor were these results readily accessible, especially for second-floor residents. During a resident meeting, it was found that none of the residents knew about the survey results' location on the first floor. The Activities Director noted that survey results were previously available on the second floor but were removed during a remodel. The Administrator confirmed that survey results were only available on the first floor, and second-floor residents would need staff assistance to access them.
The facility failed to maintain a homelike environment, with issues such as wall damage, broken picture frames, and burned-out lights. A resident reported their room was excessively cold, requiring extra comforters and wearing a hat indoors. Despite complaints, the room's temperature fluctuated significantly, and the Maintenance Director did not regularly check the temperature. Temperature readings confirmed the room and bathroom were colder than typical comfort levels.
The facility failed to notify the Office of the State Long Term Care Ombudsman about the hospitalization of three residents, which is a requirement for ensuring advocacy. Residents with conditions such as dementia, heart disease, spinal cord compression, and congestive heart failure were hospitalized without the Ombudsman being informed. Staff members, including the administrator and social services director, were unaware of the notification requirement.
The facility failed to properly label and store food items in the kitchen and snack/resident refrigerators, leading to potential risks of food spoilage and cross-contamination. Observations revealed undated or expired items, including macaroni, whipped topping, gelatin, waffles, garden burgers, garlic bread sticks, meat, Danish rolls, and cheese. Staff confirmed the improper practices, and the administrator acknowledged the expectation for proper labeling and dating of all food.
A facility failed to provide a resident with a written notice of its bed hold policy at the time of transfer to a hospital. The resident, admitted with dementia and heart disease, was discharged to an acute care hospital without receiving the required notification. This lack of documentation was confirmed by the DNS.
A resident admitted with paralysis and infection had a care plan indicating a preference for wearing a shirt and using a call light. Observations showed the resident wearing a hospital gown and rarely using the call light, instead calling out for assistance. Staff confirmed these changes, but the care plan was not updated, risking unmet care needs.
A facility failed to inform a resident's representative, who was the POA, of changes in financial coverage. The resident, with severe cognitive impairment, signed a NOMNC form without the representative's knowledge, leading to private pay status without notification. The Social Services Director and Administrator acknowledged the oversight.
Failure to Ensure Resident Access to Survey Results
Penalty
Summary
The facility failed to ensure that residents were aware of their right to review survey results and did not make these results readily accessible, particularly for residents on the second floor. During a resident meeting, it was revealed that none of the eight residents present were aware of the survey results' location on the first floor near the elevator. Additionally, it was noted that most second-floor residents could not easily access the first floor without staff assistance. Observations confirmed that no survey results were accessible on the second floor. The Activities Director mentioned that survey results were previously available on the second floor but were removed during a remodel, and she believed most residents were unaware of their availability. The Administrator confirmed that survey results were only available by the first-floor entrance and had not been on the second floor for six years, suggesting that second-floor residents could request staff assistance to view them.
Environmental and Temperature Deficiencies in Resident Rooms
Penalty
Summary
The facility failed to maintain a homelike and comfortable environment for residents, as evidenced by multiple observations of environmental deficiencies across two of the three halls reviewed. Specific issues included wall damage with missing paint and exposed drywall in several rooms, a broken picture frame with sharp edges in the 300 hall, and burned-out overhead lights in the dining room and hallways. These deficiencies were acknowledged by the facility's Administrator and Maintenance Director, indicating a need for corrective action. Additionally, a resident admitted with a right foot wound reported that their room was excessively cold, requiring extra comforters and wearing a hat indoors to stay warm. Despite complaints to staff, the room's temperature fluctuated significantly, sometimes being too hot or too cold. The Maintenance Director admitted to not regularly checking the room's temperature, despite its history of temperature complaints. Temperature readings taken during the survey confirmed the resident's room and bathroom were colder than typical comfort levels, with temperatures recorded at 69 degrees in the room and 65 degrees in the bathroom.
Failure to Notify Ombudsman of Resident Hospitalizations
Penalty
Summary
The facility failed to notify the Office of the State Long Term Care Ombudsman about the hospitalization of three residents, which is a requirement for ensuring advocacy. Resident 40, who was admitted with dementia and heart disease, was discharged to an acute care hospital, but there was no documentation indicating that the Ombudsman was informed. The facility's administrator confirmed that they did not notify the Ombudsman of discharged residents. Similarly, Resident 87, admitted with spinal cord compression, was sent to the hospital without the Ombudsman being notified. Staff 13, responsible for social services, was unaware of the requirement to notify the Ombudsman. Resident 339, with congestive heart failure, was also hospitalized without notification to the Ombudsman. Both the social services director and the administrator confirmed the lack of notification for these hospitalizations.
Improper Food Storage and Labeling in Facility
Penalty
Summary
The facility failed to ensure proper labeling and storage of food items in the kitchen and snack/resident refrigerators, which could lead to food spoilage and cross-contamination. During an observation, several items were found undated or past their expiration dates, including a plastic container of macaroni with red meat sauce, whipped topping, and gelatin. In the freezer, there were waffles dated over two months prior, garden burgers with freezer burn, and undated garlic bread sticks and meat. The walk-in refrigerator contained Danish rolls with unclear freezing and thawing dates, whipped topping, and cheese, all improperly labeled or stored. Staff members, including a cook and the dietary manager, confirmed the improper storage and labeling of these items. The dietary manager discarded the expired items and acknowledged the lack of proper labeling and dating. Additionally, a snack/resident refrigerator contained an undated and unlabeled plate of food from a previous meal, which was removed by the administrator, who also acknowledged the expectation for all food to be labeled and dated. These deficiencies in food storage practices placed residents at risk for potential infections from foodborne pathogens.
Failure to Provide Bed Hold Policy Notification
Penalty
Summary
The facility failed to provide a written notice of its bed hold policy to residents at the time of transfer to a hospital, as required. This deficiency was identified during a review of the case of Resident 40, who was admitted to the facility in December 2023 with diagnoses including dementia and heart disease. On February 26, 2024, Resident 40 was discharged to an acute care hospital. However, a review of the resident's health record revealed no documentation indicating that the resident was notified of or provided with a copy of the facility's bed hold policy prior to the discharge. This oversight was confirmed by Staff 2, the Director of Nursing Services (DNS), on July 1, 2024.
Failure to Update Care Plan for Resident's Clothing Preferences and Call Light Use
Penalty
Summary
The facility failed to revise and update the care plan for a resident who was admitted in November 2023 with diagnoses including paralysis and infection. The resident's comprehensive care plan indicated a preference for wearing a shirt even when staying in bed and required the call light to be within reach, encouraging its use. However, observations from June 24 to June 27, 2024, showed the resident wearing a hospital gown throughout the day, contrary to the care plan. Interviews with staff members revealed that the resident rarely used the call light and instead called out for assistance, indicating a change in behavior and preferences that were not reflected in the care plan. Staff members, including CNAs and an RN, confirmed that the resident did not express a preference for wearing a shirt or gown and did not consistently use the call light as previously noted. Despite these changes, the care plan was not updated to reflect the resident's current needs and preferences. This oversight placed the resident at risk for unmet care needs, as the care plan did not accurately guide staff in providing personalized care based on the resident's current condition and preferences.
Failure to Notify Resident's Representative of Financial Coverage Changes
Penalty
Summary
The facility failed to ensure that the representative of a resident with severe cognitive impairment was informed in writing of changes in financial coverage. The resident, diagnosed with Alzheimer's disease, was admitted for skilled care and was unable to make serious medical decisions. Despite this, the facility provided a Notice of Medicare Non-Coverage (NOMNC) form to the resident, who signed it, indicating that covered services would end on a specific date. The resident continued to stay in the facility as a private pay resident after the coverage ended, but there was no evidence that the resident's representative, who was also the Power of Attorney (POA), was informed of this change or the right to appeal. The resident's representative, identified as Witness 2, stated that she had informed the Social Services Director of her role as POA and her responsibility for making all medical and financial decisions for the resident. However, she was not provided with the NOMNC or any notification of financial liabilities. The facility's Administrator admitted to having the resident sign the form due to time constraints and did not notify the representative. This oversight placed the resident and their representative at risk of unknown financial liabilities and a lack of knowledge regarding the right to appeal the decision.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 383 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Gresham
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Fairlawn Health And Rehab Of Cascadia | 1.9 mi | — | 4 | 0 |
| Gresham Post Acute Care And Rehabilitation | 3 mi | — | 26 | 0 |
| Village Manor Of Cascadia | 4.2 mi | — | 0 | 0 |
| Marquis Centennial Post Acute Rehab | 4.8 mi | — | 1 | 0 |
| Village Health Care | 5.3 mi | — | 2 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Regency Gresham Nursing & Rehabilitation Center.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.