Home / Washington / Issaquah
805 Front Street, Issaquah, WA 98027 · King County · (425) 392-1271
140 certified beds, about 93 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1967
CMS Care Compare ratings, data as of September 1, 2026 · CCN 505004 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on March 27, 2025, inspectors cited 13 health deficiencies (the Washington average is 15.8, the national average 9.2).
Of 56 health citations since October 2022, 3 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $48,663 in the last three years; the largest was $48,663, and the latest is dated February 6, 2024.
Nurses and nurse aides worked 4.08 hours per resident per day, against 4.36 across Washington and 3.86 nationally. Registered nurses accounted for 0.59 of those hours.
42.4% of nursing staff left within the year CMS measured (Washington average 45.1%).
CMS links it to Avamere, an affiliated group of 27 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 56 health citations on file.
Inspectors wroteBased on interview and record review, the facility failed to ensure a Pre-admission Screening and Resident Review (PASRR - a process to determine if a potential nursing home resident had mental health/intellectual disability needs which required further assessment/treatment) assessment was accurate to reflect the residents' mental health conditions and/or obtained prior to admission for 4 of 6 (Residents 56, 16, 32, & 8), and 1 supplemental (Resident 61) residents reviewed for PASRR. This failure placed residents at risk for inappropriate nursing home placement and/or not receiving timely and necessary services to meet their mental health needs.
Inspectors wroteBased on observation, interview, and record review the facility failed to establish and maintain an infection prevention and control program designed to provide a safe and sanitary environment to help prevent the transmission of communicable diseases. The facility failed to ensure staff performed Hand Hygiene (HH) before and after resident care and failed to follow a contact precaution sign for a resident with Transmission Based Precautions. The facility failed to establish a water management program that assessed and monitored measures to prevent the growth of Legionella (bacteria that could cause a serious lung infection), and other opportunistic waterborne pathogens in the facility's water systems. These failures placed residents at risk for the development of contagious, communicable diseases, and an unclean environment.
Inspectors wroteBased on interview and record review, the facility failed to ensure funds were reimbursed to the resident and/or representative or the state Office of Financial Recovery (OFR), within 30 days of resident discharge or death, for 4 (Residents 234, 235, 237, & 236) of 7 discharged residents reviewed. This failure caused a delay in reconciling residents' accounts within 30 days as required.
Inspectors wroteBased on observation, interview, and record review the facility failed to initiate, log, investigate, and/or resolve grievances identified for 2 (Residents 14 & 56) of 2 sample residents reviewed for grievances. Staff failure to oversee the grievance process and track grievances through to their conclusions, placed residents at risk for unmet care needs.
Inspectors wroteBased on interview and record review, the facility failed to ensure a system by which residents and/or their representatives received required written notices at the time of transfer/discharge, or as soon as practicable for 2 (Residents 35 & 56) of 5 residents reviewed for hospitalizations. Failure to ensure written notification was provided to the resident and/or the resident's representative, in a language and manner they understood, placed residents at risk for not having an opportunity to make informed decisions about transfers/discharges.
Inspectors wroteBased on interview and record review, the facility failed to ensure the Minimum Data Set (MDS -an assessment tool) accurately reflected the status for 2 (Resident 80 & 5) of 19 residents reviewed for accuracy of assessments. This failure placed the residents at risk for unmet care needs and a diminished quality of life.
Inspectors wrote<Resident 61> According to a 02/11/2025 Quarterly MDS, Resident 61 had multiple medically complex diagnoses including stroke and required the use of a feeding tube (a tube to supply nutrients and fluids to the body). Review of an 11/05/2024 feeding tube CP showed a revised 12/02/2024 intervention for Resident 61 to receive diabetic tube feeding formula four times daily with a total volume of 1320 milliliters (ml) per 24 hours. An 11/05/2024 nutritional problem CP showed a revised 02/10/2025 intervention for a fiber tube feeding formula four times daily with a total volume of 1440 ml per 24 hours. Review of Resident 61's physician orders showed a 01/02/2025 tube feeding order for the fiber formula to be administered four times daily. Observations on 03/21/2025 at 10:21 AM showed a container of the fiber tube feeding formula hanging at Resident 61's bedside. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure: Physician's Orders (POs) were followed and medications were given within ordered parameters for 5 (Residents 5, 231, 32, 56, & 16), POs were clarified as needed for 1 (Resident 5), and nurses signed only for tasks completed for 1 (Resident 5) of 19 sample residents reviewed. The facility failed to document administered medications for 1 (Resident 239) supplemental resident reviewed for medication pass. These failures left residents at risk for unmet care needs and other negative health outcomes.
Inspectors wroteBased on observation, interview, and record review the facility failed to provide assistance with Activities of Daily Living (ADLs) for 3 (Residents 77, 56, & 5) of 19 sample residents who were assessed to be dependent on staff for ADLs. The failure to provide ADL assistance as required left residents at risk for poor hygiene, diminished feelings of self-worth, and other negative health outcomes.
Inspectors wroteBased on interview and record review, the facility failed to ensure the physician's orders and resident records were updated to accurately reflect the resident's wishes for Cardiopulmonary Resuscitation (CPR - the act of performing chest compressions and providing breaths to mimic the heartbeat and breathing) status as directed by the Physician Orders for Life Sustaining Treatment (POLST) form for 2 (Residents 33 & 6) of 5 residents reviewed for CPR. This failure placed residents at risk for not receiving care in accordance with the resident's and/or resident's representative decision-making if their heart stopped beating or breathing stopped.
Inspectors wroteBased on observation, interview, and record review the facility failed to develop and implement individualized activity plans and ensure activity programs met the needs of each resident for 2 of 5 (Residents 40 & 5) residents reviewed for activities. Failure to consistently implement meaningful individual activity plans left residents at risk for boredom, frustration, isolation, and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to accurately assess for the safety of and obtain and implement physician's orders to leave the facility independently for 1 (Resident 240) of 1 residents reviewed for safety, failed to ensure appropriate safety measures to prevent a fall were implemented for 1 (Resident 5) of 2 residents reviewed for falls, and, to ensure safe resident smoking and perform quarterly smoking assessments for 1 (Resident 6) of 1 resident reviewed for smoking. These failures placed all residents at risk for injury, harm, and continued falls.
Inspectors wroteBased on interview and record review, the facility failed to obtain timely laboratory services to meet the needs of 2 (Residents 5 & 8) of 5 residents reviewed for unnecessary medications. Failure to obtain physician ordered blood tests for residents who were assessed to require this service, placed residents at risk for delayed treatment and services.
Inspectors wroteBased on observation, interview and record review, the facility failed to implement their abuse and neglect policy for 1 of 1 resident (Resident 35) reviewed for injuries of unknown origin. Facility failure to identify, report, and investigate, multiple bruisesof unknown origin to Resident 35's upper/middle/lower back, both breasts, and knee placed Resident 35 at risk for potential continued abuse and psychosocial harm and all residents at risk for abuse, and psychosocial harm. An Immediate Jeopardy (IJ) was called on 01/31/2024 at 5:15 PM related to CFR 483.12 F-607, Develop/Implement Abuse/Neglect Policies. The IJ was determined to have begun 01/24/2024 when the bruises were initially identified by staff. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 1 of 5 sampled residents (Resident 61) reviewed for Pressure Ulcers (PUs), received the necessary treatment and services, consistent with professional standards of practice to prevent new ulcers from developing. Resident 61 experienced harm when they developed a facility acquired coccyx (tailbone) and inner left knee PU when staff did not consistently implement ordered pressure offloading measures and the resident was not consistently repositioned in bed. This failure placed all other residents at risk for PU development, and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 1 of 6 sampled residents (Resident 61), reviewed for Pain Management received the necessary treatment and services as ordered to manage pain with wound care. Resident 61 experienced harm and self-reported severe levels of pain during wound care when the facility failed to consistently premedicate the resident with ordered as needed pain relieving medication 30-60 minutes prior to dressing changes. This failure placed all other residents at risk for potentially unnecessary pain during wound care, and a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure a Registered Nurse (RN) provided at least eight hours of direct care supervision per day for 4 of 51 days reviewed. This failure placed residents at risk for delay in resident assessments, identification of changes in condition, provision of care and services outside the scope of practice of the Licensed Practical Nurse (LPN), and unmet care needs.
Inspectors wroteBased on interview and record review, the facility failed to provide the required Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN - a required form that outlined the transfer of financial liability from the nursing facility to the Medicare beneficiary) for 2 of 2 residents (Residents 66 & 26) and 1 closed record (Resident 75) reviewed for liability notices, who remained in the facility after their Medicare Part A skilled nursing and rehabilitation services ended. This failure placed the residents at risk for not being fully informed of the cost of continued SNF services necessary for decision-making.
Inspectors wroteBased on observation and interview, the facility failed to provide a home like environment on 4 of 4 halls (Halls 100, 200, 300, and 400). The failure to ensure resident rooms had window coverings that provided full privacy (Halls 200 & 300), free of wall gouges (Halls 200, 300, & 400), were cleaned thoroughly (300 Hall), and clean linen storage was free of dirt, stains and food waste placed residents at risk for compromised privacy, and a less-than-homelike environment.
Inspectors wroteBased on interview and record review, the facility failed to ensure a system by which residents received required written notices at the time of transfer/discharge, or as soon as practicable, for 5 (Residents 35, 57, 13, 68, & 26) of 5 residents reviewed for hospitalization. Failure to ensure written notification to the resident and/or the resident's representative of the reasons for the discharge in writing and in a language and manner they understood, placed residents at risk for a discharge that was not in alignment with the resident's stated goals for care and preferences.
Inspectors wroteBased on observations, interview, and record review the facility failed to ensure 5 of 22 residents (Residents 1, 31, 25, 66, & 46) whose Minimum Data Sets (MDS- an assessment tool) were reviewed reflected the resident's condition accurately. This failure placed residents at risk for the lack of and/or inappropriate care planning, unidentified and/or unmet care needs, and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure Care Plans (CPs) were updated and/or revised as needed to reflect person-centered care for 5 of 22 sample residents (Residents 8, 1, 25, 35, & 46) whose CPs were reviewed. This failure left residents at risk for unmet care needs, inappropriate care, and other negative health outcomes.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure: Physician's Orders (POs) were followed and medications were given within ordered parameters for 6 (Residents 8, 68, 178, 1, 31, &10), POs were clarified as needed for 1 (Resident 8), nurses signed only for tasks completed for 1 (Resident 68), and POs were obtained to monitor skin issues for 1 (Resident 19) of 22 sample residents reviewed. These failures left residents at risk for unmet care needs, unneeded treatment, and other negative health outcomes.
Inspectors wroteBased on observation, interview, and record review the facility failed to provide assistance with Activities of Daily Living (ADLs) for 5 of 8 (Residents 45, 19, 35, 46, & 4) who were assessed to be dependent on staff for ADLs. The failure to provide ADL assistance as required left residents at risk for poor hygiene, diminished feelings of self-worth, and other negative health outcomes.
Inspectors wroteBased on observation, interview, record review the facility failed to ensure 5 of 9 residents (Residents 46, 49, 61, 1, & 25) reviewed for Restorative Nursing Program (RNP) services received the care and services they were assessed to require. These failures placed residents at risk for decline in Range of Motion (ROM), increased dependence on staff, and a decreased quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 3 of 5 residents (Residents 1, 19, & 40) reviewed for respiratory care were provided care and services consistent with professional standards of practice. The facility's failure to deliver oxygen therapy according to physician ordered flow rates (Resident 1, 19, & 40) and maintain oxygen equipment (Resident 1) placed residents at risk for potential negative outcomes such as over or under oxygenation, respiratory discomfort, infections, and a decreased quality of life.
Inspectors wroteBased on observation and interview, the facility failed to ensure food was distributed in a sanitary manner. The failure to ensure food was distributed in a fashion to prevent exposure to airborne pathogens left residents at risk for food borne illness, food contamination, less than palatable food, and other negative outcomes.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 2 (Resident 62 & 26) of 2 residents noted with medications at bedside, were assessed by nursing staff to safely self-administer medications, prior to allowing the residents to do so. Failure to obtain required Physician's Orders (POs), complete a self-medication assessment to establish clinical appropriateness and safety for these residents, placed the residents at risk for medication errors and adverse medication interactions.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide reasonable accommodations to ensure a Television (TV) was within visual reach for 2 of 2 residents (Resident 5, & 66) whose physical environment were reviewed. This failure caused unnecessary discomfort to Resident 5 and 66 and placed residents at risk for unmet psychosocial needs and a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure a written notification regarding a room change, including the reason for the move, was provided as required for 1 of 3 residents (Residents 66) reviewed for choices/room changes. This failure detracted Resident 66 and their representative's right to freely consent to the room move/change and placed residents and/or their representatives at risk for not being informed, feelings of powerlessness, and a diminished quality of life.
Inspectors wrote<Resident 26> Based on interview and record review the facility failed to ensure residents had the appropriate Advance Directive (AD) in place for 1 of 5 (Residents 26) reviewed for ADs. The facility failed to obtain a copy from residents (Resident 26) with an existing AD and make the documentation readily available in the medical records and accessible to facility staff. These failures placed residents at risk of losing their right to have their stated preferences/decisions honored regarding medical treatment and end-of-life care.
Inspectors wroteBased on interviews and record review, the facility failed to initiate and complete a thorough grievance investigation for 1 of 4 residents (Residents 66) reviewed for missing personal property. The facility failed to ensure there was resolution coming from the resident and/or the resident representative regarding their lost property and how the event would affect their quality of life if left unresolved. These failures placed residents at risk for frustration and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to report identified skin issues for 1of 2 residents (Resident 35) reviewed for abuse/neglect. Facility failure to report multiple bruises of unknown origin to Resident 35's upper/middle/lower back, both breasts, and knee, placed Resident 35 at risk for repeated incidents and unidentified abuse and/or neglect.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a Significant Change Minimum Data Set (SCSA- an assessment tool) was initiated timely for 1 of 22 (Resident 5) reviewed for a significant change assessment. This failure placed residents at risk for unidentified and unmet care needs and, a diminished quality of life.
Inspectors wroteBased on interview, observation, and record review the facility failed to ensure a Significant Change Minimum Data Set (MDS - an assessment tool) was completed as required for 1 (Resident 68) of 22 sample residents reviewed. The failure to identify the need to complete a Significant Change MDS left residents at risk for unassessed care needs, inappropriate care, and other negative health outcomes.
Inspectors wroteBased on observation, interview, and record review, the facility failed to obtain and implement mental health interventions for 2 of 5 residents (Residents 5 & 8) reviewed for Pre-admission Screening and Resident Review (PASRR). This failure placed residents at risk for receiving inadequate mental health interventions, an increase in avoidable behaviors, and a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure a Pre-admission Screening and Resident Review (PASRR - a process to determine if a potential nursing home resident had mental health needs/intellectual disability and required further assessment/treatment) assessment was obtained and/or accurate to reflect the residents' mental health conditions for 2 of 5 residents (Resident 31 & 8) and 1 supplemental resident (Resident 1) reviewed for PASRR. This failure placed residents at risk for inappropriate nursing home placement and/or not receiving timely and necessary services to meet their mental health needs.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a person-centered comprehensive Care Plan (CP) was developed and implemented for 1 of 22 residents (Resident 46) whose CP was reviewed. Failure to address the individualized care needs for each resident with identified depression and signs and symptoms of mood problems placed residents at risk for inconsistent and/or inadequate care, worsening depression, and a decreased quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 2 of 22 (Residents 45, & 19) sampled residents reviewed for non-pressure skin alterations and 1 of 1 (Resident 59) reviewed for hospice coordination. The failure to ensure residents skin was assessed and findings treated and/or monitored, and coordination between the facility and hospice services left residents at risk for unmet care needs, and decreased quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents received necessary treatment and assistive devices to maintain hearing function for 1 of 2 (Resident 68) residents reviewed for hearing. The failure to respond timely after identifying adaptive devices were not functioning adequately left residents at risk for communication difficulty, frustration, and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 2 of 4 residents (Residents 35 & 46) whose physical environment reviewed was free from accident hazards. The facility failed to identify Resident 35's fall, provide supervision, and clear surroundings of clutter. The facility failed to position Resident 46's bed safely in their room. These failures placed the residents at risk for unidentified falls, bodily entrapment, and potential injuries that could affect the residents' quality of life and safety.
Inspectors wroteBased on interview and record review, the facility failed to ensure sufficient staff to meet resident needs related to the Restorative Nursing Program (RNP) for 5 of 9 residents (Residents 1, 25, 46, 49, & 61) reviewed for RNP. These failures left residents at risk for unmet care needs, worsening Range of Motion (ROM), and other negative health outcomes.
Inspectors wroteBased on interview and record review, the facility failed to ensure the arbitration agreement was signed by the resident's Durable Power of Attorney (DPOA) for financial affairs as required for 1 of 3 residents (Resident 46) whose arbitration agreements were reviewed. This failure placed Resident 46 and residents at risk of forfeiture of their right to a jury or court trial and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe and sanitary environment to help prevent the transmission of communicable diseases. The facility failed to consistently perform Hand Hygiene (HH) before and after resident care/contact and staff failed to ensure equipment was cleaned after use. These failures placed the residents and staff at risk for development of contagious, communicable infections and disease.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure services provided met professional standards for 2 of 3 residents (Resident 1 & 3) reviewed. The facility nursing staff failed to clarify physician's orders for 1 of 3 residents (Resident 3), and follow manufacturer's recommendations for 1 of 3 residents (Resident 1). These failures placed residents at risk for medication errors, delay in treatment, and adverse outcomes.
Inspectors wroteBased on observation, interview, and record review the facility failed to provide assistance with Activities of Daily Living (ADLs), related to showers for two of four residents (Resident 1 & 2) reviewed for showers. The facility's failure to provide residents who were dependent on staff to meet hygiene needs placed residents at risk for poor hygiene, embarrassment, and diminished quality of life.
Inspectors wroteBased on interview, observation, and record review the facility failed to obtain and/or failed to provide assistance in the formulation of an Advanced Directive (AD - a document describing a resident's wishes for care if they became incapacitated) for 6 of 18 residents (Residents 50, 48, 19, 64, 47, & 78) reviewed for ADs. This failure left residents at risk for losing the right to have their preferences and choices honored during emergent and end-of-life care.
Inspectors wroteBased on interview and record review the facility failed to have a system in place that ensured grievances were identified, immediately investigated, documented, resolved promptly with notification to the resident of findings, and action taken to correct concerns for 1 of 1 resident (Resident 63) reviewed for a resident-to-resident verbal altercation and additional reports from multiple unidentified residents during Resident Council (RC) meetings for 2 of 3 months (July 2022 & September 2022) reviewed. This failure detracted from the facility's ability to protect resident rights and placed residents at risk for resident-to-resident altercations, unresolved concerns, feeling unheard, frustrated, diminished self-worth, and decreased quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to implement a system to ensure residents were provided fluids within ordered parameters for 2 of 2 residents (Resident 78 & 38) reviewed for hydration and 1 supplemental resident (Resident 52). This failure placed residents at risk for medical complications, unmet needs, and diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to accurately assess 5 of 20 residents (Residents 19, 64, 17, 52, & 48) reviewed for Minimum Data Set (MDS - an assessment tool). Failure to ensure accurate assessments placed residents at risk for unidentified and/or unmet needs.
Inspectors wroteBased on interview and record review, the facility failed to obtain and/or ensure Pre-admission Screening and Resident Review (PASRR) assessments accurately reflected residents' mental health conditions for 3 (Residents 19, 52, & 64) of 5 residents reviewed for unnecessary medications. These failures placed residents at risk for inappropriate placement and/or not receiving timely and necessary services to meet their mental health care needs.
Inspectors wroteResident 50 According to the 08/23/2022 Significant Change MDS, Resident 50 had severe cognitive impairment and diagnoses including a progressive neurological condition and muscle weakness. The MDS showed Resident 50 required extensive assistance with personal hygiene. Record Review showed Resident 50 had a revised 04/28/2021 Actual Self Care Deficit . CP. The CP indicated Resident 50 had a self care deficit related to personal hygiene and directed staff to provide extensive assistance for personal hygiene. Observation on 10/06/2022 9:18 AM showed Resident 50 had considerable nose hair growing in [NAME] extending from both nostrils. Resident 50's nose hair was observed to remain untrimmed on 10/07/2022 at 12:56 PM, 10/10/2022 at 8:07 AM, and on 10/11/2022 at 8:25 AM. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the residents enviornment was free of accident hazards by implementing their system for securing and storing hazardous toxic chemicals in 1 of 4 shower rooms, 1 of 2 soiled utility rooms, and 1 of 1 tub room. This failure placed residents at risk for injury.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a medication error rate of less than 5 percent (%). Failure of 3 of 3 nurses (Staff P, Q, & I) to properly administer 3 of 25 medications for 3 of 4 residents (Residents 84, 48, and 38) observed during medication pass, resulted in a medication error rate of 12%. These failures placed the residents at risk for adverse side effects and/or reduced medication effectiveness due to improper administration.
Inspectors wroteBased on observation, interview and record review, the facility failed: to ensure drugs and biologicals were secured and stored at the appropriate temperature; expired medications and biologicals were disposed of timely in accordance with professional standards for 1 of 4 medication carts and 1 of 2 medication rooms reviewed; and ensure medications were secured for 3 of 3 residents (Residents 48, 78, & 69) observed with medications at the bedside. These failures placed residents at risk for receiving expired medications, medication errors, and non-assessed, self-administration of medications by residents.
Inspectors wroteBased on interview and record review, the facility failed to ensure pneumococcal vaccines were provided for 1 of 5 residents (Residents 64) reviewed for immunizations and infection control. This failure placed residents at risk of acquiring, transmitting, and/or experiencing potentially avoidable complications from pneumococcal disease.
35 fire safety citations on file: 9 on March 27, 2025, 25 on February 6, 2024, 1 on October 12, 2022.
| Date | Penalty | Amount or length |
|---|---|---|
| February 6, 2024 | Fine | $48,663 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Washington | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 4.08 | 4.36 | 3.86 |
| Registered nurses | 0.59 | 0.94 | 0.69 |
| All nursing staff on weekends | 3.65 | 3.80 | 3.42 |
| Nurse aides | 2.56 | ||
| Licensed practical nurses | 0.93 | ||
| Nursing staff turnover (share who left in a year) | 42.4% | 45.1% | 45.8% |
| Registered nurse turnover | 46.7% | 45.4% | 42.9% |
| Administrators who left | 1 |
CMS expects 4.70 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.26 on weekdays and 3.65 on weekends, 14% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.65 in April to June 2025 to 4.08 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 4.08 | 0.59 | 4.26 | 3.65 | 0.0% | 0 of 90 | 93 |
| Oct to Dec 2025 | 4.29 | 0.58 | 4.51 | 3.73 | 0.0% | 0 of 92 | 83 |
| Jul to Sep 2025 | 4.40 | 0.64 | 4.60 | 3.89 | 1.4% | 0 of 92 | 79 |
| Apr to Jun 2025 | 4.65 | 0.58 | 4.88 | 4.08 | 2.6% | 0 of 91 | 84 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Washington, Jan to Mar 2026 | 4.21 | 0.90 | 4.44 | 3.66 | 3.7% | 0.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Washington, all employers | |||
| CNAs (nursing assistants) | $23.65 | $22.59 to $27.85 | 30,270 |
| LPNs and LVNs | $39.98 | $36.98 to $45.18 | 6,780 |
| Registered nurses | $59.71 | $49.57 to $64.54 | 69,260 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Washington | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 22.3 | 14.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.3 | 1.0 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.9 | 1.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.1 | 2.6 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.3 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 17.8 | 17.2 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 2.6 | 4.3 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 12.5 | 15.1 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 25.0 | 19.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 15.7 | 13.4 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.0 | 1.3 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.5 | 1.5 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Avamere Rehabilitation of Issaquah's Medicare short-stay residents. On returning residents home or to the community, CMS rates it better than the national rate (64.4% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
64.4% this home
Better than the national rate
US median of homes 51.5% · Washington: 71 better, 16 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 200 eligible stays.
8.0% this home
No different from the national rate
US median of homes 10.7% · Washington: 7 better, 0 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 196 eligible stays.
5.9% this home
No different from the national rate
US median of homes 7.1% · Washington: 4 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 123 eligible stays.
50.0% this home
Median of homes: Washington61.4% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 34 residents counted.
0.0% this home
Median of homes: Washington0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 64 residents counted.
1.0% this home
Median of homes: Washington1.4% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 64 residents counted.
96.4% this home
Median of homes: Washington98.3% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 28 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: ISSAQUAH OPERATIONS LLC. CMS links this home to Avamere, a group of 27 nursing homes averaging 3 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Ariso LLC | Direct ownership interest | Organization | 02/01/2023 | |
| Ari Operations, LLC | Indirect ownership interest | Organization | 02/01/2023 | |
| Avamere Group LLC | Indirect ownership interest | Organization | 02/01/2023 | |
| Karl Rickard Miller Jr Revocable Trust | Indirect ownership interest | Organization | 02/01/2023 | |
| Miller, Karl | Indirect ownership interest | Individual | 02/01/2023 | |
| Midcap Finco LLC | 5% or greater security interest | Organization | 02/01/2023 | |
| Cavallo, Glen | Managing control - governing body | Individual | 06/01/2025 | |
| Feakin, Cody | Managing control - governing body | Individual | 06/01/2025 | |
| Funderberg, Michelle | Managing control - governing body | Individual | 06/01/2025 | |
| Garcia, Roberto | Managing control - governing body | Individual | 02/01/2026 | |
| Inskeep, Todd | Managing control - governing body | Individual | 06/01/2025 | |
| Kofstad, Mary | Managing control - governing body | Individual | 06/01/2025 | |
| Reid, Misty | Managing control - governing body | Individual | 06/01/2025 | |
| Staples, Carolyn | Managing control - governing body | Individual | 10/01/2025 | |
| Strunk, Colby | Managing control - governing body | Individual | 06/01/2025 | |
| Vanderzanden, Carrie | Managing control - governing body | Individual | 06/01/2025 | |
| Avamere Health Services LLC | Operational/managerial control | Organization | 02/01/2023 | |
| Avamere Skilled Advisors LLC | Operational/managerial control | Organization | 02/01/2023 | |
| Midcap Finco LLC | Operational/managerial control | Organization | 02/01/2023 | |
| Fanunal, Loriel | Operational/managerial control | Individual | 01/02/2023 | |
| Feakin, Cody | Operational/managerial control | Individual | 12/01/2025 | |
| Feliu Vargas, Jose | Operational/managerial control | Individual | 10/20/2025 | |
| Fisher, Tonya | Operational/managerial control | Individual | 01/19/2026 | |
| Fowler, Katherine | Operational/managerial control | Individual | 02/28/2025 | |
| Garcia, Roberto | Operational/managerial control | Individual | 02/01/2026 | |
| Hobbs, Samantha | Operational/managerial control | Individual | 02/01/2023 | |
| Kofstad, Mary | Operational/managerial control | Individual | 02/13/2024 | |
| Mokashi, Samiksha | Operational/managerial control | Individual | 03/07/2025 | |
| Nesterenko, Oksana | Operational/managerial control | Individual | 08/08/2022 | |
| Presley, Yolanda | Operational/managerial control | Individual | 01/06/2025 | |
| Reid, Misty | Operational/managerial control | Individual | 01/02/2025 | |
| Avamere Health Services LLC | Adp of the SNF | Organization | 07/12/2025 | |
| Avamere Skilled Advisors LLC | Adp of the SNF | Organization | 07/12/2025 | |
| Consolidated Billing Services Inc | Adp of the SNF | Organization | 02/01/2023 | |
| Incovate Solutions, LLC | Adp of the SNF | Organization | 02/01/2023 | |
| Moss Adams LLP | Adp of the SNF | Organization | 02/01/2023 | |
| Pacific Medical Specialty Group | Adp of the SNF | Organization | 08/08/2022 | |
| Rande Holdings, LLC | Adp of the SNF | Organization | 06/01/2024 | |
| Sabra Health Care Limited Partnership | Adp of the SNF | Organization | 02/01/2023 | |
| Sabra Health Care Reit Inc | Adp of the SNF | Organization | 02/01/2023 | |
| Sabra Health Care, LLC | Adp of the SNF | Organization | 02/01/2023 | |
| Snapmedtech,inc. | Adp of the SNF | Organization | 09/08/2025 | |
| Fanunal, Loriel | Adp of the SNF | Individual | 01/02/2023 | |
| Feakin, Cody | Adp of the SNF | Individual | 01/01/2025 | |
| Feliu Vargas, Jose | Adp of the SNF | Individual | 10/20/2025 | |
| Fowler, Katherine | Adp of the SNF | Individual | 02/28/2025 | |
| Funderberg, Michelle | Adp of the SNF | Individual | 12/31/2024 | |
| Games, Kim | Adp of the SNF | Individual | 08/15/2024 | |
| Garcia, Roberto | Adp of the SNF | Individual | 02/01/2026 | |
| Hobbs, Samantha | Adp of the SNF | Individual | 02/01/2023 | |
| Hokenson, Laura | Adp of the SNF | Individual | 02/01/2025 | |
| Inskeep, Todd | Adp of the SNF | Individual | 01/21/2022 | |
| Kofstad, Mary | Adp of the SNF | Individual | 02/13/2024 | |
| Mokashi, Samiksha | Adp of the SNF | Individual | 07/11/2025 | |
| Nesterenko, Oksana | Adp of the SNF | Individual | 08/08/2022 | |
| Nielson, Charles | Adp of the SNF | Individual | 02/02/2026 | |
| Presley, Yolanda | Adp of the SNF | Individual | 01/06/2025 | |
| Reid, Misty | Adp of the SNF | Individual | 01/02/2025 | |
| Staples, Carolyn | Adp of the SNF | Individual | 10/05/2023 | |
| Strunk, Colby | Adp of the SNF | Individual | 09/06/2022 | |
| Vanderzanden, Carrie | Adp of the SNF | Individual | 01/02/2025 | |
| Weisert, Melanie | Adp of the SNF | Individual | 05/26/2023 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
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