Provider Details - Fernwood Supportive Living at Madrona Grove | Licensed Long-Term Care Settings Search

Fernwood Supportive Living at Madrona Grove

13505 SE RIVER ROAD
Portland, OR 97222

Administrator name: Javan Nelson

ID: 38L544
Status: Open
Type: Nursing Facility
Licensed beds: 16
Accepts Medicaid: No
Memory Care: No

Owner: Rose Villa, Inc.

Owner since: 10/21/1993

If you have questions about this provider or its inspection and compliance history, please contact the provider at the phone number listed above.

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Licensing inspections evaluate a provider’s compliance with rules and laws. Licensing surveyors look at a variety of factors, including quality of care and services provided, as well as the condition of the provider’s physical structure, equipment, staffing levels, policies, procedures and finances. Under federal requirements, nursing facilities receive recertification inspections and inspections following a complaint investigation. The inspections represent a snapshot of the provider’s compliance with regulatory requirements at the time the inspection took place.

Records that are highlighted and show the icon, occurred under the current provider owner.

Provider Details - Fernwood Supportive Living at Madrona Grove
Date Date From To	Event ID	Inspection type(s) Inspection type(s)	Deficiencies cited Deficiencies cited Between And
6/4/2026	233A5A	Re-Licensure, Recertification	6
8/7/2025	1D297E	Re-Licensure, Recertification	12
8/6/2024	WGX2	Complaint, Licensure Complaint, State Licensure	2
4/19/2024	RPC2	Re-Licensure, Recertification, State Licensure	3
6/9/2023	KPIP	Complaint, Licensure Complaint, State Licensure	3
2/13/2023	MTPE	Complaint, Licensure Complaint, Re-Licensure, Recertification, State Licensure	10
2/7/2022	CZ70	Focused Infection Control, Other-Fed	1
9/14/2021	YTGV	State Licensure	0

8 records found

The information on this tab comes from a database called iQIES, which is managed by the Centers for Medicare & Medicaid Services (CMS). Sometimes CMS changes how the data is organized. When that happens, the information may not show up here until our system is updated to match those changes. If this tab is empty and you have questions about a facility’s survey, please email nf.licensing@odhs.oregon.gov for help.

This list shows confirmed (substantiated) instances of abuse from 2010 onward. Open investigations and complaints that are being appealed by the provider are not listed. To learn more about abuse definitions, see: Definitions of Abuse

Records that are highlighted and show the icon, occurred under the current provider owner.

Provider Details - Fernwood Supportive Living at Madrona Grove
Date Date From To	Report number Report number	Allegation Allegation Failed to address resident's behavior Failed to assure resident rights Failed to protect resident from financial exploitation Failed to protect resident from inappropriate sexual contact Failed to protect resident from mental or emotional abuse Failed to protect resident from physical abuse Failed to protect resident from verbal abuse Failed to provide a safe medication administration system Failed to provide safe environment	Level Level Between And	Type Type Abuse: Financial abuse Abuse: Neglect Abuse: Sexual abuse Abuse: Verbal/Mental abuse
5/3/2024	OR0005020700	Failed to assure resident rights	2	Abuse: Neglect
7/1/2022	OR0003658000	Failed to protect resident from inappropriate sexual contact	3	Abuse: Neglect
11/4/2021	OR0003293300	Failed to protect resident from inappropriate sexual contact	3	Abuse: Neglect
11/21/2020	OR0002736700	Failed to protect resident from physical abuse	2	Abuse: Neglect
7/29/2020	OR0002576800	Failed to protect resident from physical abuse	2	Abuse: Neglect
3/6/2020	OR0002385500	Failed to protect resident from verbal abuse	2	Abuse: Neglect
10/9/2019	OR0002143500	Failed to provide safe environment	3	Abuse: Sexual abuse
12/5/2017	OR0001408600	Failed to provide safe environment	3	Abuse: Neglect
11/30/2015	BH166064	Failed to protect resident from financial exploitation	3	Abuse: Financial abuse
8/2/2015	BH179127	Failed to protect resident from mental or emotional abuse	3	Abuse: Verbal/Mental abuse

14 records found | Page 1 of 2

This list shows confirmed (substantiated) licensing violations from 2010 onward. Open investigations and complaints that are being appealed by the provider are not listed.

Records that are highlighted and show the icon, occurred under the current provider owner.

Provider Details - Fernwood Supportive Living at Madrona Grove
Date Date From To	Report number Report number	Allegation Allegation Failed to address resident's behavior Failed to adequately care plan related to falls Failed to assure resident rights Failed to assure resident was safe Failed to provide oversight and monitoring of change of condition Failed to provide safe environment Failed to report potential or suspected abuse Failed to submit timely or adequate staffing documentation	Level Level Between And	Type Type Licensing Violation
1/14/2026	CALMS - 00097464	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
1/26/2023	OR0004008200	Failed to provide safe environment	2	Licensing Violation
1/25/2023	OR0004143700	Failed to provide safe environment	2	Licensing Violation
10/8/2019	SR20037	Failed to report potential or suspected abuse	2	Licensing Violation
9/15/2018	BH180922	Failed to provide safe environment	2	Licensing Violation
6/7/2018	BH188477	Failed to provide safe environment	2	Licensing Violation
4/21/2017	BH171046	Failed to address resident's behavior	2	Licensing Violation
1/15/2017	OR0001230000	Failed to adequately care plan related to falls	2	Licensing Violation
8/14/2016	BH167151	Failed to assure resident was safe	2	Licensing Violation
8/9/2015	BH179214	Failed to assure resident was safe	2	Licensing Violation

15 records found | Page 1 of 2

Formal regulatory actions can range from a condition placed upon a license due to non-compliance or a notice to revoke a license. This section of the website currently displays only license conditions dating back to 2010 and no other types of regulatory action. Additional records will be added over time as resources allow.

Records that are highlighted and show the icon, occurred under the current provider owner.

Provider Details - Fernwood Supportive Living at Madrona Grove
	Sanction Sanction	Allegation Allegation Failed to protect resident from inappropriate sexual contact	Type Type License Condition	Effective date Effective date From To	End date End date From To	Actions
	NFCD23-00010	Failed to protect resident from inappropriate sexual contact	License Condition	2/14/2023	5/30/2023

1 record found

Provider Details - Fernwood Supportive Living at Madrona Grove

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