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Highland Health and Rehabilitation of Cascadia

2400 Samish Way, Bellingham, WA 98229 · Whatcom County · (360) 734-4800

44 certified beds, about 37 residents a day · For profit - Corporation · Medicare and Medicaid since 1972

Certified for Medicaid Certified for Medicare
Overall
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
3 of 5

CMS Care Compare ratings, data as of September 1, 2026 · CCN 505140 · See it on Medicare.gov · Compare with other homes

The record in brief

At its most recent standard inspection, on August 7, 2025, inspectors cited 8 health deficiencies (the Washington average is 15.8, the national average 9.2).

Of 37 health citations since July 2023, 4 were rated as actual harm or immediate jeopardy to residents.

CMS lists 3 fines totaling $63,884 in the last three years; the largest was $41,291, and the latest is dated February 13, 2026.

Nurses and nurse aides worked 3.93 hours per resident per day, against 4.36 across Washington and 3.86 nationally. Registered nurses accounted for 1.22 of those hours.

62.5% of nursing staff left within the year CMS measured (Washington average 45.1%).

CMS links it to Cascadia Healthcare, an affiliated group of 47 nursing homes.

Health inspections

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.

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

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 37 health citations on file.

Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
4G
0H
0I
Potential for more than minimal harm
24D
9E
0F
Potential for minimal harm
0A
0B
0C
February 13, 2026Complaint inspection · 4 citations
  1. G
    Provide for the safe, appropriate administration of IV fluids for a resident when needed.
    F694 · Quality of Life and Care · Actual harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 17, 2026
    Inspectors wroteBased on interview and record review, the facility failed to ensure the nursing staff used professional standards of care and aseptic (to prevent healthcare associated infections, surgical site infections and laboratory contamination) technique when changing Resident 20's PICC line [a peripherally inserted central catheter (PICC) is a long, soft, flexible tube inserted into a vein in the upper arm and advanced to a large vein above the heart] dressing. Resident 20 experienced harm when they required an emergency transfer to the emergency department (ED) to have their PICC line replaced, and additional diagnostic procedures (ultrasound and Xray) performed when their PICC line was cut with unclean and unsterile scissors. Additionally, this failed practice placed the resident at serious risk for central line associated blood stream infection.
  2. E
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) March 17, 2026
    Inspectors wroteBased on interview and record review the facility failed to ensure residents were provided all physician ordered medications on 13 of 14 days reviewed for 20 residents. This failed practice disrupted the residents' continuity of care and placed residents at risk of not having their medical needs met.
  3. D
    Respond appropriately to all alleged violations.
    F610 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 17, 2026
    Inspectors wroteBased on interview and record review the facility failed to conduct a complete and thorough investigation of mistreatment for 1 of 1 resident (Resident 20) who was sent to the emergency department due to a Registered Nurse (RN) accidentally cutting a residents peripherally inserted central catheter (PICC) line during a PICC line dressing change. This failed practice prevented the facility from identifying why the incident occurred, identifying the nursing staff's competency improvement needs which placed residents at risk.
  4. D
    Post nurse staffing information every day.
    F732 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 17, 2026
    Inspectors wroteBased on interview and record review the facility failed to ensure the daily nurse staffing posting was completed daily with the total number of actual nursing hours worked along with the resident census from 01/07/2026 to 02/13/2026 for a total of 37 days. This failed practice prevented the residents and visitors' ability to readily view the nurse staffing information.
December 17, 2025Complaint inspection · 1 citation
  1. D
    Provide appropriate pressure ulcer care and prevent new ulcers from developing.
    F686 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) January 27, 2026
    Inspectors wroteBased on interview and record review the facility failed to ensure 1 of 3 residents (Resident 1) who were at risk of pressure injuries (PI), did not develop an avoidable PI. The facility failed to implement preventive PI interventions for Resident 1. This failed practice resulted in the development of a deep tissue injury (DTI) of Resident 1's left heel which caused the resident significant discomfort. This failed practice placed other residents at risk of pressure injuries, pain and decreased quality of life.
August 7, 2025Standard inspection, Complaint inspection · 8 citations
  1. E
    Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
    F584 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a safe, clean, comfortable and homelike environment on 2 of 2 units and the main dining room. Failure to ensure a comfortable interior in the dining room, unit halls free of unpleasant odors, adequate supply of linens, and perform needed repairs in resident's rooms placed residents at risk for decreased quality of life.
  2. E
    Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
    F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure proper storage and labeling of insulin (injectable medication that regulates blood sugar) in 2 of 2 medication carts (North and South carts) when reviewed for medication storage. This failure placed residents at risk of receiving expired medications, ineffective treatment, and a diminished quality of life.
  3. E
    Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
    F947 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on record review and interview, the facility failed to develop, implement and maintain a process to ensure annual performance reviews were completed for 3 of 5 staff (Staff P, Q, R) and that Nursing Assistant Certified (NAC) staff had the required 12 hour annual in-service training for 4 of 5 staff (Staff O, P, Q, R) reviewed for competent nursing staff. The failure to ensure NAC's had annual performance reviews to assess areas of weakness so the facility could provide in-service training and/or NACs received 12 hours annual in-service training placed residents at risk of less than competent care and services from staff.
  4. D
    Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
    F585 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on observation, interview, and record review the facility failed to initiate, investigate, and resolve a grievance for 1 of 1 sampled residents (Resident 3) reviewed for grievances. This failure placed residents at risk for emotional distress and a diminished quality of life.
  5. D
    Ensure services provided by the nursing facility meet professional standards of quality.
    F658 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on interview and record review, the facility failed to ensure professional standards were met for 3 of 5 residents (Residents 3, 6, and 26) reviewed for unnecessary medication review. The facility failed to recognize and ensure parameters were met for blood pressure medication administration and diabetes (blood sugar levels in blood are unmanaged) medication management for the residents. The facility failed to notify the medical provider when the resident's blood sugar levels and blood pressures were beyond the ordered parameters. These failures placed the residents at risk for adverse outcomes, medication errors, complications, and unmet needs.
  6. D
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    F677 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure 1 of 4 residents (Resident 13) reviewed for activities of daily living, received adequate bathing according to the resident's plan of care. This failure placed the resident at risk of poor hygiene and a diminished quality of life.
  7. D
    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
    F756 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on interview and record review, the facility failed to ensure pharmacy recommendations were completed in the medical record for 2 of 6 residents (Residents 26 and 30) reviewed for unnecessary medications. This failure placed the residents at risk for delay in necessary medication changes, incomplete medical records, and adverse side effects.
  8. D
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) September 22, 2025
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff were compliant with Infection Prevention and Control Guidelines and standards of practice for 1 of 4 staff members (Staff T, Nursing Assistant Certified - NAC) reviewed for hand hygiene, 1 of 3 residents (Resident 35) reviewed for transmission-based precautions (TBP), and 1 of 1 residents (Resident 5) reviewed for oxygen use. The facility failed to ensure the staff were wearing appropriate personal protective equipment (PPE) in accordance with recommended national standards, failed to ensure staff were compliant with appropriate hand hygiene practices during meal tray delivery, and failed to ensure oxygen tubing supplies were stored and maintained properly. These failures placed all residents and staff at risk of potential infection.
February 20, 2025Complaint inspection · 1 citation
  1. D
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 3, 2025
    Inspectors wroteBased on interview and record review the facility failed to ensure 1 of 1 resident (Resident 1) who had a history of hypersexuality, and inappropriate touching was sufficiently supervised resulted in a resident-to-resident sexual contact. This failed practice placed Resident 1 and Resident 2 at risk of diminished quality of life.
August 7, 2024Complaint inspection · 1 citation
  1. E
    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
    F725 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure there was sufficient nursing staff for 3 of 4 sampled residents (Residents 1, 2, and 4) reviewed for care and services. The facility had insufficient nursing staff to answer call lights and to provide care and services for a cognitively impaired resident resulting in the residents having unmet needs. These failures placed all residents at risk for accidents and diminished quality of life.
July 30, 2024Standard inspection · 10 citations
  1. E
    Ensure services provided by the nursing facility meet professional standards of quality.
    F658 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure professional standards were met for 2 of 2 halls (North and South) reviewed for medication administration, and 1 of 1 (Resident 27) residents reviewed for physician consultations. The facility failed to ensure that the paper medication administration record (MAR) had the physician orders printed clear and complete to allow for licensed staff to properly administer the prescribed medications during an internet outage where the licensed staff were unable to access the electronic medication administration records (eMAR). The facility failed to ensure the licensed staff followed a physician order, and failed to obtain a specialist referral that was ordered by the physician. These failures placed the residents at risk for adverse outcomes, medication errors, complications, and unmet needs.
  2. E
    Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
    F726 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on interview and record review, the facility failed to ensure Nursing Assistants Certified (NACs) had the appropriate competencies, skills sets and proficiencies to provide nursing and related services for each resident in accordance with the facility assessment when nursing staff failed to demonstrate the knowledge, skills and abilities to perform nursing services for 5 of 5 sampled staff (Staff H, I, Q, R, and S) reviewed for competent nursing staff. This failure placed residents at risk for unmet care needs and a diminished quality of life.
  3. E
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff were compliant with Infection Prevention and Control Guidelines and standards of practice for 1 of 2 nurses (Staff D, Licensed Practical Nurse) during medication administration, for 1 of 1 laundry room, and failed to review and revise their infection control program annually. The facility failed to ensure the staff followed appropriate infection control practices during medication administration when the licensed staff did not use a barrier during medication administration or perform hand hygiene prior to administering medications. The facility failed to have a system in place where the staff were knowledgeable, trained and able to initiate appropriate processes for the handling of potential contaminated linens to prevent cross contamination. [...]
  4. D
    Ensure residents have reasonable access to and privacy in their use of communication methods.
    F576 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on interview and record review, the facility failed to ensure residents had access to Saturday mail deliveries for 2 of 6 sampled residents (Residents 27 and 2) reviewed for mail delivery. The failure to ensure residents had access to Saturday mail services placed them at risk for isolation, frustration and diminished quality of life.
  5. D
    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
    F636 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the Resident Assessment Instrument (RAI), an assessment of a resident's needs, strengths, goals, and preferences, included thorough summaries of the Care Area Assessments (CAA), an assessment of a specific resident care or medical issue, to holistically analyze the plan of care for 3 of 4 residents (4, 9, and 33) reviewed for comprehensive assessments. This failure placed the residents at risk of not having appropriate services provided based on the resident's individualized needs.
  6. D
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    F690 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident with an indwelling urinary catheter (a hollow, partially flexible tube that collects urine from the bladder and leads to a drainage bag) received appropriate treatment and services to prevent catheter-associated urinary tract infections (CAUTIs) for 1 of 1 sampled resident (Resident 3) reviewed for indwelling urinary catheter care/management. The facility failed to develop individualized plans for the prevention of CAUTIs including developing individualized, specific clinical indications for changing the catheters and/or catheter bags and to avoid routine irrigation/accessing of the closed catheter system. These failures placed residents with indwelling urinary catheters at an increased risk for UTI's and associated complications.
  7. D
    Ensure each resident’s drug regimen must be free from unnecessary drugs.
    F757 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on interview and record review, the facility failed to ensure residents remained free of unnecessary drugs for 1 of 5 sampled residents (Resident 10) reviewed for unnecessary drugs and for 1 of 1 resident (Resident 3) reviewed for bowel medications. The facility failed to provide nonpharmacological interventions for pain prior to giving as needed (PRN) pain medications and they failed to follow hold orders for bowel medications which resulted in the residents receiving unnecessary pain and bowel medications and placed them at risk for adverse medication-related side effects and a diminished quality of life.
  8. D
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    F842 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on interview and record review, the facility failed to maintain complete and accurate clinical records for 1 of 4 sampled residents (Resident 3) reviewed for urinary catheter care and services. The failure to consistently document urinary catheter output per the resident's orders placed the resident at risk for hydration issues, unmet care needs, and diminished quality of life.
  9. D
    Implement a program that monitors antibiotic use.
    F881 · Infection Control · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on interview and record review, the facility failed to ensure the infection prevention and control Antibiotic Stewardship Program (ASP, a system-wide implementation of measures for monitoring/tracking of antibiotics along with reducing the risk of unnecessary antibiotic use) was implemented for one of two residents (Resident 3). This failure increased the resident's risk for development of multidrug-resistant organisms (a bacteria that are resistant to many antibiotics) along with the potential for unidentified nursing care trends that identify risk related to infection prevention. This failure had the potential for adverse outcomes associated with unnecessary or inappropriate antibiotic use and a decrease in quality of life for all facility residents.
  10. D
    Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
    F947 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on record review and interview, the facility failed to develop, implement and maintain an in-service training program to ensure 2 of 2 Nursing Assistants (Staff H and I) reviewed for the required 12 hour per year nurse aide training received the required amount of annual training. The failure to ensure Nursing Assistants Certified (NACs) received 12 hours per year in-service training placed residents at risk of less than competent care and services from staff.
July 1, 2024Complaint inspection · 1 citation
  1. D
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) September 10, 2024
    Inspectors wroteBased on observation, interview, and record review the facility failed to ensure resident with diabetes mellitus 2 (DM- a medical condition in which the body doesn't use insulin properly), received care and services needed to manage their blood glucose (BG - the amount of concentrated sugar in the blood) for 1 of 4 sampled residents (Resident 1) reviewed for diabetic management. This failure place other residents at risk for unmet care needs and medical complications. Findings Included . Review of the facility policy titled, Diabetes Mellitus, Guidelines for Management, revised 08/01/2023, documented the goal was to quickly restore normal cerebral function, prevent hyperglycemia (high BG) or hypoglycemia (low BG), recognize, treat, or prevent complications commonly associated with DM. [...]
April 29, 2024Complaint inspection · 3 citations
  1. D
    Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
    F740 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 21, 2024
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure behavioral health needs were identified and met for 1 of 1 resident (Resident 2) reviewed for behavioral-emotional health. Failure to identify behavioral health needs and utilize person-centered interventions developed by an interdisciplinary team (IDT) placed residents with behavioral needs, at risk for unidentified behavior triggers, unmet behavioral needs, refusal of care, self-neglect, lack of behavioral services and support, loss of dignity, and diminished quality of life.
  2. D
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 21, 2024
    Inspectors wroteBased on interview, and record review the facility failed to ensure pharmacy services were provided to meet the residents needs for 3 of 4 residents (Resident 1, 2, and 3) reviewed for new admissions. The facility's failure to ensure medications were acquired and administered as ordered on the day of admission and the facility's failure to follow their process for when medications were not available placed residents at risk of diminished quality of health and diminished quality of life.
  3. D
    Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
    F921 · Environmental · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 21, 2024
    Inspectors wroteBased on observation, and interview, the facility failed to provide a clean and sanitary environment for 1 of 1 residents' shower room. This failed practice decreased Resident 4's desire to bathe, did not promote a clean and comfortable environment for the residents to be bathed and placed the residents at risk of a diminished quality of life.
March 12, 2024Complaint inspection · 1 citation
  1. D
    Provide safe and appropriate respiratory care for a resident when needed.
    F695 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 28, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure 1 of 1 resident (Resident 1) reviewed for respiratory care and services was provided care consistent with professional standards of practice. The facility failed to ensure there was a physician order in place prior to administering a continuous positive airway pressure (CPAP) machine (a medical device that provides pressurized air) was set to the ordered flow rate. This failure placed residents at risk for receiving care and services that were not physician ordered, unmet care needs, diminished quality of life and negative outcomes.
January 9, 2024Complaint inspection · 1 citation
  1. G
    Provide appropriate pressure ulcer care and prevent new ulcers from developing.
    F686 · Quality of Life and Care · Actual harm, isolated · found on a complaint visit · Past noncompliance: already fixed when inspectors found it
    Inspectors wroteBased on interview, and record review the facility failed to ensure staff provided the necessary assessment, interventions, monitoring of the impacted skin area, and care for 1 of 1 resident (Resident 1) who was identified to have a Deep Tissue Injury (DTI) from a knee brace/immobilizer and subsequently developed an avoidable unstageable pressure ulcer/pressure Injury (PU/PI). Resident 1 experienced harm when they developed an unidentified wound to the area under their brace (also known as an immobilizer - a medical device that stabilizes your knee joint and holds it in place) and this practice placed all other residents with a brace or appliance at risk of the development of a PU/PI. The facility corrected the above deficient practice prior to the initiation of the abbreviated survey on 12/21/2023. [...]
November 22, 2023Complaint inspection · 1 citation
  1. G
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · Actual harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) December 19, 2023
    Inspectors wroteBased on interview and record review, the facility failed to ensure 1 of 3 sampled residents (Resident 1), reviewed for falls, received supervision with two-person assist with transfers and was not left unattended while on a bedside commode (BSC), had the effectiveness of current interventions evaluated, and had additional fall measures implemented to prevent future falls. Resident 1 was harmed when they had five falls within a nine-week period from their admission to the facility while they were self-transferring to or from the toilet or BSC, and during the last fall, the resident experienced a fractured hip. This failed practice placed all residents at risk for prevention of falls and possible injury.
October 19, 2023Complaint inspection, Infection control · 3 citations
  1. G
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · Actual harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 15, 2023
    Inspectors wroteBased on interview and record review the facility failed to thoroughly provide professional standards of care and services, for 1 of 1 resident (Resident 1) reviewed for wound care. The facility failed to timely and accurately assess the resident's surgical wound site, follow physician orders as indicated post-surgical amputation of a toe on the resident's right foot, monitor and assess other open areas to the resident's right foot, left foot, and coccyx (tailbone), manage a wound vac (vacuum assisted closure device that assists in wound healing) device, and communicate concerns and status of the surgical wound to the surgeon. Resident 1 experienced harm, when they were hospitalized for significant worsening of their surgical wound site on their right foot that contributed to a below knee amputation (BKA) of their right leg.
  2. D
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    F550 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 15, 2023
    Inspectors wroteBased on interview, and record review, the facility failed to ensure a dignified existence was maintained for 1 of 1 sampled resident (Resident 1) reviewed for resident rights. The facility failed to ensure Resident 1 was dressed appropriately when they were sent out on public transportation to their dialysis treatment for up to 6 hours. This failure placed the resident at risk for a diminished self-worth and a diminished quality of life when they felt exposed at a public appointment.
  3. D
    Develop and implement policies and procedures for flu and pneumonia vaccinations.
    F883 · Infection Control · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · infection control inspection · Corrected (the home has a date of correction) November 15, 2023
    Inspectors wroteBased on interview and record review the facility failed to ensure pneumococcal vaccines (a vaccine that protects against pneumococcal infections that can lead to serious infections such as pneumonia and blood infections) were offered to 1 of 5 residents (Resident 2) reviewed for immunizations and infection control. This failed practice placed the residents at risk for illness, spread of a communicable disease and a diminished quality of life.
July 28, 2023Standard inspection · 2 citations
  1. E
    Provide activities to meet all resident's needs.
    F679 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) August 30, 2023
    Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a consistent activity program to meet the needs of 5 of 7 seven (Resident 2, 23, 13, 16, and 18) residents reviewed for activities. This failure created the potential for residents to miss out on opportunities of interest to maintain a meaningful life.
  2. D
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 30, 2023
    Inspectors wroteBased on interview and record review, the facility failed to develop a comprehensive care plan, based on the activity assessment, for two of seven residents (Resident 2 and 23) reviewed for comprehensive care plans. This failure created the potential to negatively impact the residents' quality of life.

Fire safety inspections

35 fire safety citations on file: 9 on August 7, 2025, 13 on July 30, 2024, 13 on July 28, 2023.

Every fire safety citation35 citations
  1. F
    Establish procedures for tracking staff and patients during an emergency.
    E 18 · August 7, 2025 · Corrected (the home has a date of correction)
  2. F
    Establish policies and procedures including evacuation.
    E 20 · August 7, 2025 · Corrected (the home has a date of correction)
  3. F
    Establish emergency prep training and testing.
    E 36 · August 7, 2025 · Corrected (the home has a date of correction)
  4. F
    Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
    K 222 · August 7, 2025 · Corrected (the home has a date of correction)
  5. F
    Have approved installation, maintenance and testing program for fire alarm systems.
    K 345 · August 7, 2025 · Corrected (the home has a date of correction)
  6. F
    Have generator or other power source capable of supplying service within 10 seconds.
    K 918 · August 7, 2025 · Corrected (the home has a date of correction)
  7. F
    Ensure that testing and maintenance of electrical equipment is performed.
    K 921 · August 7, 2025 · Corrected (the home has a date of correction)
  8. E
    Keep aisles, corridors, and exits free of obstruction in case of emergency.
    K 211 · August 7, 2025 · Corrected (the home has a date of correction)
  9. D
    Have properly installed electrical wiring and gas equipment.
    K 511 · August 7, 2025 · Corrected (the home has a date of correction)
  10. F
    Conduct risk assessment and an All-Hazards approach.
    E 6 · July 30, 2024 · Corrected (the home has a date of correction)
  11. F
    Address patient/client population and determine types of services needed.
    E 7 · July 30, 2024 · Corrected (the home has a date of correction)
  12. F
    Address subsistence needs for staff and patients.
    E 15 · July 30, 2024 · Corrected (the home has a date of correction)
  13. F
    Establish procedures for tracking staff and patients during an emergency.
    E 18 · July 30, 2024 · Corrected (the home has a date of correction)
  14. F
    Create arrangements with other facilities to receive patients.
    E 25 · July 30, 2024 · Corrected (the home has a date of correction)
  15. F
    List the names and contact information of those in the facility.
    E 30 · July 30, 2024 · Corrected (the home has a date of correction)
  16. F
    Establish methods for sharing information.
    E 33 · July 30, 2024 · Corrected (the home has a date of correction)
  17. F
    Provide family notifications of emergency plan.
    E 35 · July 30, 2024 · Corrected (the home has a date of correction)
  18. F
    Establish emergency prep training and testing.
    E 36 · July 30, 2024 · Corrected (the home has a date of correction)
  19. F
    Conduct testing and exercise requirements.
    E 39 · July 30, 2024 · Corrected (the home has a date of correction)
  20. F
    Have restrictions on the use of highly flammable decorations.
    K 753 · July 30, 2024 · Corrected (the home has a date of correction)
  21. F
    Have generator or other power source capable of supplying service within 10 seconds.
    K 918 · July 30, 2024 · Corrected (the home has a date of correction)
  22. F
    Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.
    K 926 · July 30, 2024 · Corrected (the home has a date of correction)
  23. F
    Develop and maintain an Emergency Preparedness Program (EP).
    E 4 · July 28, 2023 · Corrected (the home has a date of correction)
  24. F
    Conduct risk assessment and an All-Hazards approach.
    E 6 · July 28, 2023 · Corrected (the home has a date of correction)
  25. F
    Address patient/client population and determine types of services needed.
    E 7 · July 28, 2023 · Corrected (the home has a date of correction)
  26. F
    Develop Emergency Preparedness policies and procedures.
    E 13 · July 28, 2023 · Corrected (the home has a date of correction)
  27. F
    Develop a communication plan.
    E 29 · July 28, 2023 · Corrected (the home has a date of correction)
  28. F
    Provide emergency officials' contact information.
    E 31 · July 28, 2023 · Corrected (the home has a date of correction)
  29. F
    Establish emergency prep training and testing.
    E 36 · July 28, 2023 · Corrected (the home has a date of correction)
  30. F
    Establish staff and initial training requirements.
    E 37 · July 28, 2023 · Corrected (the home has a date of correction)
  31. F
    Ensure that testing and maintenance of electrical equipment is performed.
    K 921 · July 28, 2023 · Corrected (the home has a date of correction)
  32. E
    Address subsistence needs for staff and patients.
    E 15 · July 28, 2023 · Corrected (the home has a date of correction)
  33. D
    Install corridor and hallway doors that block smoke.
    K 363 · July 28, 2023 · Corrected (the home has a date of correction)
  34. D
    Have properly installed electrical wiring and gas equipment.
    K 511 · July 28, 2023 · Corrected (the home has a date of correction)
  35. D
    Ensure proper usage of power strips and extension cords.
    K 920 · July 28, 2023 · Corrected (the home has a date of correction)

Fines and payment denials

DatePenaltyAmount or length
February 13, 2026Fine $10,545
January 9, 2024Fine $12,048
October 19, 2023Fine $41,291

A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

MeasureThis homeWashingtonUnited States
All nursing staff (RN, LPN and aides)3.934.363.86
Registered nurses1.220.940.69
All nursing staff on weekends3.503.803.42
Nurse aides2.17
Licensed practical nurses0.54
Nursing staff turnover (share who left in a year)62.5%45.1%45.8%
Registered nurse turnover62.5%45.4%42.9%
Administrators who left1

CMS expects 3.99 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

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 4.10 on weekdays and 3.50 on weekends, 15% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 22.7% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.87 in April to June 2025 to 3.93 in January to March 2026.

QuarterAll nursing staffRegistered nursesWeekdaysWeekendsContract staff shareDays with no RN hoursResidents a day
Jan to Mar 20263.931.224.103.50 22.7%0 of 9037
Oct to Dec 20253.681.293.923.07 8.1%0 of 9236
Jul to Sep 20254.011.444.283.33 7.5%0 of 9236
Apr to Jun 20253.871.244.143.17 21.1%0 of 9138
United States, Jan to Mar 20263.750.623.923.335.3%0.5% of days
Washington, Jan to Mar 20264.210.904.443.663.7%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

Staff pay at this home

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.

Official wage estimates for Washington

JobMedianMiddle halfEmployed
Washington, all employers
CNAs (nursing assistants)$23.65$22.59 to $27.8530,270
LPNs and LVNs$39.98$36.98 to $45.186,780
Registered nurses$59.71$49.57 to $64.5469,260
United States, nursing care facilities
CNAs (nursing assistants)$20.67$17.91 to $22.55534,270
LPNs and LVNs$33.86$30.05 to $37.40188,210
Registered nurses$41.11$37.85 to $47.68142,270

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.

How staff pay reports work · CNA pay by state

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

MeasureThis homeWashingtonUS
Percentage of long-stay residents whose need for help with daily activities has increased
Long Stay residents, 2025Q2-2026Q1
6.814.213.9
Percentage of long-stay residents with a catheter inserted and left in their bladder
Long Stay residents, 2025Q2-2026Q1
0.01.00.8
Percentage of long-stay residents with a urinary tract infection
Long Stay residents, 2025Q2-2026Q1
1.81.61.6
Percentage of long-stay residents experiencing one or more falls with major injury
Long Stay residents, 2025Q2-2026Q1
4.32.63.2
Percentage of short-stay residents who newly received an antipsychotic medication
Short Stay residents, 2025Q2-2026Q1
0.81.31.6
Percentage of long-stay residents whose ability to walk independently worsened
Long Stay residents, 2025Q2-2026Q1
4.317.214.1
Percentage of long-stay residents with pressure ulcers
Long Stay residents, 2025Q2-2026Q1
4.94.34.6
Percentage of long-stay residents who received an antipsychotic medication
Long Stay residents, 2025Q2-2026Q1
17.615.115.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission
Short Stay residents, 20250101-20251231
27.719.923.8
Percentage of short-stay residents who had an outpatient emergency department visit
Short Stay residents, 20250101-20251231
5.813.412.0

Short-term rehab results

For a stay to recover after a hospital visit, these are the results CMS publishes for Highland Health and Rehabilitation of Cascadia's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (46.2% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.

Went home or back to the community

46.2% this home

No different from 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. 63 eligible stays.

Potentially preventable readmissions

10.2% 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. 60 eligible stays.

Infections that led to a hospital stay

6.3% 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. 42 eligible stays.

Self-care and mobility at discharge

46.1% 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. 39 residents counted.

Falls with major injury

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. 56 residents counted.

New or worsened pressure ulcers

1.6% 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. 56 residents counted.

Medication list given at discharge

100.0% 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. 23 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.

Owners and operators

Legal business name: BELLINGHAM SOUTH OF CASCADIA, LLC. CMS links this home to Cascadia Healthcare, a group of 47 nursing homes averaging 3.1 stars overall.

NameRoleTypeShareSince
Cascadia Washington Operations LLCDirect ownership interestOrganization08/01/2022
Cascadia Hc Group LLCIndirect ownership interestOrganization06/05/2025
Cascadia Healthcare LLCIndirect ownership interestOrganization08/01/2022
Cascadia Holdco LLCIndirect ownership interestOrganization06/05/2025
Hammond, OwenIndirect ownership interestIndividual08/01/2022
Laforte, StephenIndirect ownership interestIndividual06/05/2025
Nelson, TimothyIndirect ownership interestIndividual06/05/2025
White Oak Healthcare Finance LLC5% or greater security interestOrganization08/11/2022
Cascadia Services LLCOperational/managerial controlOrganization01/08/2025
Dhaliwal, NavdeepOperational/managerial controlIndividual01/09/2023
Hammond, OwenOperational/managerial controlIndividual06/05/2025
Laforte, StephenOperational/managerial controlIndividual06/05/2025
Nelson, TimothyOperational/managerial controlIndividual06/05/2025
Vance, NathanOperational/managerial controlIndividual03/23/2026
Cascadia Services LLCAdp of the SNFOrganization01/08/2025
Timberline Ohi Tenant LLCAdp of the SNFOrganization06/05/2025
Dhaliwal, NavdeepAdp of the SNFIndividual02/14/2025
Vance, NathanAdp of the SNFIndividual04/09/2026

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.

Questions to ask on a visit

Chosen from this home's own inspection record.

  1. How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 12 problems in this area, most recently on February 13, 2026: "Provide for the safe, appropriate administration of IV fluids for a resident when needed."
  2. How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 5 problems in this area, most recently on February 13, 2026: "Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist."
  3. How many nurses and aides work each shift, nights and weekends included?Inspectors cited 5 problems in this area, most recently on February 13, 2026: "Post nurse staffing information every day."
  4. When is the care plan meeting, and can family attend it?Inspectors cited 5 problems in this area, most recently on August 7, 2025: "Ensure services provided by the nursing facility meet professional standards of quality."
  5. Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.50 hours per resident per day, below the Washington average of 3.80.
  6. How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.

Other nursing homes nearby

Washington contacts for a concern about a nursing home

These are the official offices in Washington. NursingHomeClear cannot take or act on complaints.

Common questions

What is Highland Health and Rehabilitation of Cascadia's Medicare star rating?
CMS rates Highland Health and Rehabilitation of Cascadia 3 out of 5 stars overall, with 3 for health inspections, 3 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Highland Health and Rehabilitation of Cascadia get at its last inspection?
8 health deficiencies at the standard inspection on August 7, 2025. The Washington average is 15.8.
Has Highland Health and Rehabilitation of Cascadia been fined?
Yes. CMS lists 3 fines totaling $63,884 in the last three years.
Does Highland Health and Rehabilitation of Cascadia accept Medicaid?
It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Highland Health and Rehabilitation of Cascadia?
CMS lists 18 owners and managers, and links the home to Cascadia Healthcare. Legal business name: BELLINGHAM SOUTH OF CASCADIA, LLC.

Sources

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