Home / Washington / Snohomish
800 10th Street, Snohomish, WA 98290 · Snohomish County · (360) 568-3161
91 certified beds, about 81 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1989
CMS Care Compare ratings, data as of September 1, 2026 · CCN 505338 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on May 1, 2026, inspectors cited 19 health deficiencies (the Washington average is 15.8, the national average 9.2).
Of 59 health citations since November 2023, 6 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 3 fines totaling $188,426 in the last three years; the largest was $142,428, and the latest is dated April 14, 2026.
Nurses and nurse aides worked 3.78 hours per resident per day, against 4.36 across Washington and 3.86 nationally. Registered nurses accounted for 0.95 of those hours.
56.0% 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.
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 59 health citations on file.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents who engaged in smoking had adequate supervision to protect residents and/or staff from potential fire hazards for 2 of 3 residents (Resident 51 and 32) reviewed for smoking. This failure placed all residents at serious risk for injury related to unsafe smoking practices and constituted an Immediate Jeopardy (IJ). The failed practice resulted in an IJ on 04/26/2026 when the facility failed to ensure the residents' environment was safe from burns and fire. The IJ was removed on 04/28/2026 after the facility provided a safe receptacle for properly disposing of cigarette butts, reassessed and educated staff and residents of the facility's no smoking policy and confiscated residents smoking paraphernalia.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure food items were stored under sanitary conditions in two of two nourishment refrigerators. Failure to ensure refrigerator temperatures were monitored and maintained placed residents at risk for food borne illness.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the facility assessment addressed the physical environment, equipment, services, and other physical plant considerations that are necessary to care for its identified resident smoking population. Failure to thoroughly assess all factors associated with resident smoking placed residents at risk for adverse events related to smoking safety.
Inspectors wroteBased on interview and record review, the facility failed to provide a response to concerns voiced by 1 of 1 resident groups (Resident Council) that had concerns. The failure to respond to Resident Council about their concerns left the issues unresolved and resulted in the Resident Council process being ineffective at improving resident quality of life.
Inspectors wroteBased on interview and record review, the facility failed to periodically inform residents of their rights after residents were admitted to the facility for 7 of 7 sampled residents (Residents 7, 20, 35, 40, 49, 67 and 75) when reviewed for resident rights. This failure placed residents at risk of not being informed of their rights and a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure complete and updated Notification of Medicare Non-Coverage (NOMNC - a document informing Medicare beneficiaries that their covered services will be terminated and providing information on their appeal rights) for 4 of 4 sampled residents (Resident 15, 91, 90 and 63) reviewed for liability notice. The facility failed to provide the Skilled Nursing Facility Advanced Beneficiary Notice of Non-Coverage (SNF ABN-a form to inform their responsibilities for the services cost when Medicare discontinues) for 2 of 4 sampled residents (Resident 15 and 63) reviewed for Beneficiary Notices. The facility failed to utilize the current CMS-approved forms and failed to ensure proper complete the forms as the facility staff signed in the place of the resident and/or representatives; [...]
Inspectors wroteBased on interview and record review, the facility failed to ensure 3 of 5 residents (4,6 and 34) selected for medication review were free from unnecessary medications. This failure placed residents at risk for adverse side effects and decreased quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure 6 of 8 residents (Residents 4, 6, 9, 34, 42, and 51), reviewed for pre-admission screening and resident review (PASRR - a federal requirement which identifies individual with Serious Mental Illness (SMI) or intellectual or developmental disabilities to provide appropriate services), received the required screening for necessary services. This failure placed the resident at risk for unidentified mental health needs.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure food services met the dietary needs and preferences for residents on 2 of 2 resident units, 1 of 1 resident group and 1 of 2 residents (Resident 77) reviewed for food. Failure to ensure snacks were available, preferences were honored and alternates of similar nutritional value were provided during meals placed residents at risk for decreased quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure a system in which resident's records were accurate, complete and readily accessible for 1 of 4 residents (Resident 2) reviewed for closed record, 1 of 2 residents (Resident 9) reviewed for Advance Directive, and 1 of 1 residents (Resident 4) reviewed for Hospice Services. This failure placed the residents at risk of a delay in care or services after discharge, unmet care needs, and diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to allow residents to make choices about daily routines for 1 of 3 residents (Resident 51) reviewed for choices. The facility's failure to accommodate resident choice placed residents at risk for a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to notify the State PASRR (Pre-admission Screening and Resident Review-an assessment used to identify people [resident] referred to nursing facilities with Serious Mental Illness [SMI], intellectual disabilities [ID], or related conditions are not inappropriately placed in nursing facility for long term care) Coordinator after a significant change in mental condition for 1 of 5 residents (Resident 37), reviewed for PASRR. This failure placed the resident at risk for unmet mental health services necessary to obtain the resident's highest level of psychosocial well-being and diminished quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure professional standards were met for 2 of 5 residents (Resident 6 and Resident 52) reviewed for unnecessary medication review; 1 of 2 residents (Resident 29) for blood glucose monitoring; and 1 of 2 residents (Resident 6) for skin observation and treatment. The facility failed to ensure physician-ordered parameters were followed for blood pressure medication administration, failed to perform blood glucose (test to check sugar level in the blood) checks prior to meals, and failed to provide treatments for a wound. These failures placed the residents at risk for adverse outcomes, medication errors, infections, clinical complications, and unmet needs.
Inspectors wroteBased on interviews and record reviews, the facility failed to ensure that 1 of 1 resident (Resident 34) who had been continent of bladder prior to admission to the facility, received appropriate treatment and services to restore continence to the extent possible. This failure placed residents at an increased risk of urinary tract infections, discomfort, loss of dignity, and decreased quality of life.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure 2 of 4 residents (Residents 37 and 42) reviewed for respiratory care and services were provided care consistent with professional standards of practice. The facility failed to ensure the oxygen concentrator (a medical device that filters air to deliver concentrated medical-grade oxygen) was set to the ordered rate and failed to ensure oxygen supplies were appropriately maintained, changed regularly and dated. This failure placed residents at risk for receiving care and services that were not physician ordered, unmet care needs and potential for complications of the respiratory system.
Inspectors wroteBased on interview and record review, the facility failed to ensure residents were free from unnecessary medications for 3 of 5 residents reviewed for unnecessary medications (Residents 4,6 and 52) and 1 of 3 residents reviewed for pain management (Resident 20). Failure to follow providers orders for pain medication parameters and provide non-pharmacological interventions for pain placed residents at risk for adverse effects of unnecessary medication and decreased quality of life.
Inspectors wroteBased on observation and interview, the facility failed to store medications securely for 2 of 2 residents (Resident 37 and 49) reviewed for medications stored in their room and failed to ensure 1 of 4 medication carts and 1 of 2 treatment carts were locked when left unsupervised by staff. These failures placed residents at risk for receiving compromised or ineffective medications and for having unintended access to drugs that should have been securely stored.
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 2 of 4 residents (Resident's 11 and 79) reviewed for Enhanced Barrier Precaution (EBP- personal protective equipment (PPE) required for staff during high contact care activities), 1 of 1 observation of pericare (washing of the genitalia and buttocks), 1 random observation of medical equipment sanitation and 1 of 4 nurses (Staff U) reviewed for medication administration. The facility failed to ensure the staff to wear appropriate PPE in accordance with recommended national standards; failed to ensure staff were compliant with hand hygiene during pericare; failed to ensure appropriately disinfecting reusable medical equipment; and failed to ensure proper barriers were used for medication items. [...]
Inspectors wroteBased on interview and record review, the facility failed to implement policies and procedures for screening of potential staff to ensure the protection of residents against abuse, neglect, exploitation, or misappropriation by requesting reference checks and/or reviewing information from former employers for 4 of 4 staff (Staff F,G,H, and I ) reviewed for hiring practices. Failure to obtain references or obtain information from former employers placed residents at risk of potential abuse.
Inspectors wroteBased on interview and record review, the facility failed to develop and implement a comprehensive person-centered care plan for 4 of 4 sampled residents (Residents 1, 2, 3, and 4) reviewed for care planning. The failure to ensure the comprehensive care plan was person-centered to maintain and or attain the resident's highest practicable well-being placed the residents at risk of not receiving services and monitoring that would meet their needs, adverse health effects and a decreased quality of life.
Inspectors wroteBased on observation, interview and record review, the facility failed to obtain physician orders and provide monitoring of fall related injuries and interventions for 3 of 4 sampled residents (Residents 1, 2, 3 and 4), document fall related injuries on the reporting log for 2 of 4 sampled residents (Residents 3 and 4), and documentation of fracture in the investigation summary for 1 of 4 sampled residents (Resident 2) reviewed for accidents. The facility failure to provide documentation and monitoring of injuries, non-weight bearing status, braces and slings placed residents at risk for further injury, unmet care needs, and a diminished quality of life.
Inspectors wroteBased on interviews and record reviews, the facility failed to ensure a safe discharge plan was in place for 1 of 2 residents (Resident 1) reviewed for discharges. The facility failed to provide discharge instructions, discuss medications, notify family and provider and provide community resources upon discharge. These failures placed residents at risk of an unsafe discharge and risk for medical complications.
Inspectors wroteBased on interview, and record review, the facility failed to thoroughly investigate incidents for one of one resident (Resident 1) reviewed for medication errors. This failure prevented the facility from identifying the potential causes of the occurrence, placed residents at risk for repeated errors, substantial injury, left unanswered questions whether the incident was potentially related to neglect, and unmet care needs.
Inspectors wroteBased on interview, and record review, the facility failed to ensure 1 of 3 sampled residents (Resident 1) reviewed for intravenous (IV) hydration use was free from medication errors. Failure to follow physician orders to administer IV hydration placed the resident at risk for complications from dehydration, a decline in their condition, and decreased quality of life.
Inspectors wroteBased on interview and record review the facility failed to conduct an investigation for 1 of 3 sampled Residents (Resident 1) reviewed for falls. Failure to conduct an investigation to identify the root cause(s) and all contributing factors related to Resident 1's incident, placed the resident at risk for unidentified abuse or neglect, risk for injury, and unmet care needs.
Inspectors wroteBased on interview and record review, the facility failed to ensure 4 of 6 residents (Residents 25, 26, 59 and 60) had an accurate Pre-admission Screening and Resident Review (PASARR) on or before admission to the facility. This failure placed residents at risk for unmet care needs and at risk of not receiving appropriate mental health support/services needed.
Inspectors wroteBased on interview and record review, the facility failed to ensure residents and/or their representatives were offered the opportunity to participate in care conferences (a collaborative care plan meeting where a resident's care is discussed and coordinated by a team of health care providers, family members and residents) for 3 of 6 sampled residents (Residents 3, 27, and 60) reviewed for participation in care planning. This failure placed residents at risk of not being allowed to be involved and informed about care and services and a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to obtain and/or offer assistance to residents and/or their representatives to formulate Advance Directives (AD) for 1 of 6 residents (Resident 60) reviewed for ADs. 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 observation, interview and record review, the facility failed to review and revise care plans for 3 of 10 sampled residents (Residents 3, 34 and 31) reviewed for care planning. The failure to review and revise care plans by the interdisciplinary team placed residents at risk for unmet care needs, adverse health effects and diminished quality of life.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that the resident's environment was free from accident hazards of 1 of 3 residents (Resident 59) reviewed for environmental hazards. These failures placed residents at risk for possible injury and diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure that 2 of 6 residents (Residents 26 and 59) reviewed for unnecessary medications were free from unnecessary psychotropic medications (drugs that affect a person's mind, emotions and behavior, used to treat mental health conditions like anxiety, depression, and psychosis). These failures placed residents at risk for receiving unnecessary psychotropic medications, for adverse events and diminished quality of life. <RESIDENT 26> Resident 26 admitted to the facility on [DATE] with diagnoses to include bipolar disorder (a mental health disorder that causes extreme mood swings that include emotional highs, called mania and lows known as depression). Review of Resident 26's physician's orders on 03/26/2025, showed the following order: [...]
Inspectors wroteBased on interview and record review, the facility failed to ensure residents were free from significant medication errors for 1 of 5 residents (Resident 26) selected for medication review. This failure placed Resident 26 at risk for adverse outcome related to receiving insulin when blood sugar was below the blood sugar parameter ordered.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure 1 of 3 sampled residents (Resident 27), reviewed for dental care, received timely assistance to coordinate appropriate denture services. This failure placed residents at risk for difficulty chewing, diminished quality of life and a loss of dignity.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure facility staff used personal protective equipment (PPE) in accordance with the Centers for Disease Control (CDC) guidelines when caring for 2 of 3 sampled residents (Residents 42 and 10) with enhanced barrier precautions (EBP- infection control practices designed to reduce the spread of multidrug-resistant organisms in nursing homes by focusing on gown and glove use during high-contact resident care activities). These failures placed residents at risk for facility acquired or healthcare-associated infections and related complications and a decreased quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to comprehensively assess the increased risk for skin breakdown, follow written policy and procedures, develop, and implement timely interventions necessary to prevent the development of avoidable pressure ulcers (PUs)for 4 of 6 sampled residents (Resident 1, 2, 3 and 4), reviewed for PUs. These failures caused harm to Resident 1 who admitted to the facility with a Stage 2 PU which deteriorated into an unstageable PU with osteomyelitis (bone infection), debridement (removal of dead [necrotic] or infected skin tissue to try to help wound heal), and a hospital treatment. developed a facility acquired unstageable PU with osteomyelitis (bone infection) and Residents 2, 3, and 4 experienced harm when they developed facility acquired PU's with partial and full thickness skin loss, and pain. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to consistently implement care plan interventions related to bed height and mattress type to prevent accidents/falls for 1 of 1 sample resident (Resident 7) reviewed for falls and accident hazards. Resident 7 experienced harm when they fell out of bed and sustained a left hip fracture (broken bone), pain, and required hospitalization. These failures placed residents at risk for potential falls, injuries, and a decreased quality of life.
Inspectors wroteBased on interview, and record review, the facility failed to conduct a thorough investigation for 1 of 1 resident (Resident 1) reviewed for falls. Failure to conduct a thorough investigation to identify the root cause(s) and all contributing factors related to Resident 1's incident, placed residents at risk for unidentified abuse or neglect, risk for injury, and ineffective care planning.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure timely review and revise the care plan to accurately reflect the care needs for 1 of 1 resident (Resident 7), reviewed for timely care plan revision. This failure placed the residents at risk for unmet care needs and potential harm.
Inspectors wroteBased on interview, and record review, the facility failed to ensure the direct care data of both contract and agency staff was accurately entered into the Payroll Based Journal (PBJ, a system for tracking staffing in nursing homes) for 1 of 1 quarter (Quarter 3) for the Fiscal Year (FY) 2023(which included July 2023 through September 2023) reviewed for PBJ reporting. This failure caused the Centers for Medicare and Medicaid Services (CMS) to have inaccurate data related to nursing home staffing levels which had the potential to impact care and services provided to all the residents in the facility.
Inspectors wroteBased on observation, interview, and record review, the facility failed to consistently recognize and respond to complaints of pain and failed to consistently implement wound care recommendations related to pain management in accordance with professional standards for 1 of 3 sampled residents (Resident 55) reviewed for pain management. Resident 55 experienced harm when nursing staff failed to recognize and respond to complaints of pain and failed to implement wound care recommendations related to pain management. This failed practice placed residents at risk for unmanaged pain and a diminished quality of life.
Inspectors wroteBased on interview, and record review, the facility failed to provide the required beneficiary notices for 3 of 3 sampled residents (Residents 227, 228 and 229) reviewed for liability notices. This failure placed the residents at risk of not being fully informed of their rights to appeal the decision to end skilled services and/or the potential costs of continued services if the residents wished to stay at the facility.
Inspectors wroteBased on interview, and record review, the facility failed to ensure the Resident Assessment Instrument (RAI -instructions for when and how to use the RAI that include instruction for completion of the RAI as well as structured frameworks for synthesizing the MDS and other clinical information) Utilization Guidelines process was followed for 4 of 17 sampled residents (Residents 55, 57, 13 and 52) reviewed for comprehensive assessments. This failure placed residents at risk for inadequate care plan development and diminished quality of care.
Inspectors wroteBased on interview, and record review, the facility failed to ensure Licensed Nurses (LN's) and Nursing Assistants Certified (NAC) 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 6 sampled staff (Staff F, G, H, T, and W) reviewed for competent nursing staff. This failure placed residents at risk for unmet care needs and a diminished quality of life.
Inspectors wroteBased on observation, interview and record review, the facility failed to monitor the medication refrigerator temperatures and to ensure medications were stored in the medication room refrigerator under proper temperature controls in 2 of 2 (Hall 1 and Hall 2) medication refrigerators observed. This failure placed residents at risk for receiving compromised or ineffective vaccines and medications with unknown potency.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide meals that accommodated residents' food preferences and choices regarding types of food to eat and portion size for 7 of 8 sampled residents (Residents 50, 16, 19, 59, 52, 176, and 60) reviewed for food preferences. This failure placed residents at risk for dissatisfaction with food, weight loss, and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure 3 of 3 food workers (Staff I, J, and K) with beards had restrained their facial hair to prevent food contamination. The failure to ensure food workers restrained their facial hair placed residents at risk for food contamination and diminished quality of life.
Inspectors wroteBased on record review, and interview, the facility failed to ensure 3 of 4 sampled employees, (Staff F, Staff G, and Staff H) reviewed for training, had the required 12 hours per year of in-services and required annual dementia training. This failure placed residents at risk of less than competent care and services from staff.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents had a homelike environment for 2 of 4 sampled residents (Resident 55 and 17) reviewed for environment. This failure placed the residents at risk for decreased quality of life.
Inspectors wroteBased on interview, and record review, the facility failed to identify a significant change in status for 1 of 3 sampled residents (Resident 55), reviewed for pressure ulcers (localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device). Failure to identify and complete a Significant Change in Status assessment, according to the Resident Assessment Instrument (RAI - instructions for when and how to use the RAI that include instruction for completion of the RAI as well as structured frameworks for synthesizing the MDS and other clinical information) Criteria, placed residents at risk for inadequate care planning and a diminished quality of life.
Inspectors wroteBased on record review and interview, the facility failed to ensure the accuracy of the Minimum Data Set (MDS, assessment of care needs) for 3 of 15 sampled residents (Residents 5, 61, and 55) reviewed for accuracy of the MDS. Failure to accurately assess the residents placed them at risk for unidentified and unmet care needs.
Inspectors wroteBased on interview, and record review, the facility failed to ensure recommendations were acted upon for 1 of 5 sampled residents (Resident 52) reviewed for nutrition. Failure to review and initiate nutrition recommendations placed residents at risk for weight loss, a decline in nutritional status, and related complications. Resident 52 admitted to the facility on [DATE] with diagnoses to include iron deficiency anemia (blood lacks adequate healthy red blood cells) and Stage IV (wound exposing muscle and/or bone) pressure ulcer (bed sore). Review of Resident 52's nutrition comprehensive evaluation, dated 10/17/2023, showed the Registered Dietician (RD) recommended the resident receive ProSource (liquid protein supplement) 30 milliliters (ml) twice a day due to increased protein needs and wound healing. Review of Resident 52's nutrition review, dated 11/01/2023, showed the resident had 2. [...]
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that 1 of 2 sampled residents (Resident 61) reviewed for respiratory care were provided care consistent with professional standards of practice. Failure of the facility to ensure oxygen (O2) delivery and use of Continuous Positive Airway Pressure (CPAP, machine that uses air pressure to keep airways open) was provided according to physician orders, monitor respiratory status, and maintain oxygen equipment, placed residents at risk of discomfort and a potential negative outcome.
Inspectors wroteBased on interview, and record review, the facility failed to ensure 1 of 5 sampled residents (Resident 13) reviewed for unnecessary medications were free of significant medication errors. Failure to accurately review and transcribe admission medication orders placed residents' health and safety in jeopardy. Resident 13 admitted to the facility from the hospital on [DATE]. Review of Resident 13's current physician orders, showed an order for quetiapine (medication used to treat hallucinations and disordered thoughts) 25 milligram (mg) every 12 hours for dementia (cognitive loss) with agitation with an initiation date of 12/20/2023. There was an order for trazodone (medication for depression that is often used to help sleep) 50 mg at bedtime for sleep with an initiation date of 12/21/2023. [...]
Inspectors wroteBased on interview, and record review, the facility failed to ensure resident clinical records were complete and accurate for 2 of 24 sampled residents (Resident 60 and 65) reviewed for advance directives (AD, a resident wishes regarding medical treatment to ensure their wishes are carried out if they are unable to communicate them). The failure to ensure AD documentation was complete and accurate placed the residents at risk for not having their wishes honored.
Inspectors wroteBased on interview, and record review the facility failed to protect a cognitively impaired resident from unwanted touch for 1 of 1 resident (Resident 2) reviewed for sexual abuse. Resident 2 experienced psychosocial harm, based on a reasonable person concept, when they received a non-consensual sexual touch from Resident 1, who had been identified in the past of inappropriate behaviors and sexually suggestive statements with female staff and a history of wandering into Resident 2's room on multiple occasions. The facility failed to identify an incident of sexual abuse, report it timely to the state agency, and potentially placed cognitively impaired residents at risk for unwanted sexual touch and psychosocial harm.
Inspectors wroteBased on interview and record review, the facility failed to permit a resident to return (re-admit) to the facility for 1 of 1 sampled resident (Resident 2), reviewed for transfer to the hospital when the resident was ready to return to the facility after a hospital stay. Resident 2 experienced harm and a decreased quality of life when they expressed unnecessary psychosocial distress when the resident was not permitted to return to the facility where she had lived since June 2023, and felt they had nowhere to safely discharge.
Inspectors wroteBased on interview and record review, the facility failed to provide a written notice to the resident, resident's representative(s) and representative of the Office of the State Long-Term Care Ombudsman of an emergency transfer for 5 of 5 resident's (2, 5, 6, 7, and 8) reviewed for hospitalizations. This failure did not afford resident and/or their representative to make informed decisions about transfers and prohibited access to an advocate who could inform resident/representative of their options and rights. This failure had the potential to affect all facility-initiated discharges.
Inspectors wroteBased on interview and record review, the facility failed to provide a bed hold notice in writing at the time of a resident transfer to the hospital or within 24 hours of transfer to the hospital for 5 of 5 of sampled residents (Resident 2, 5, 6, 7, and 8) reviewed for hospitalizations. This failed practice placed the residents or their representative at risk for lack of knowledge regarding the right to hold their bed while they were at the hospital.
Inspectors wroteBased on interview and record review the facility failed to conduct a thorough investigation for 1 of 3 resident (Resident 1) reviewed for falls. Failure to conduct a thorough investigation to identify the root cause(s) and all contributing factors related to Resident 1's incident, placed residents at risk for unidentified abuse or neglect, risk for injury, and ineffective care planning.
28 fire safety citations on file: 15 on May 1, 2026, 2 on March 31, 2025, 11 on February 9, 2024.
| Date | Penalty | Amount or length |
|---|---|---|
| April 14, 2026 | Fine | $12,750 |
| February 9, 2024 | Fine | $142,428 |
| February 9, 2024 | Payment Denial | 13 days from May 9, 2024 |
| November 8, 2023 | Fine | $33,248 |
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) | 3.78 | 4.36 | 3.86 |
| Registered nurses | 0.95 | 0.94 | 0.69 |
| All nursing staff on weekends | 3.42 | 3.80 | 3.42 |
| Nurse aides | 2.24 | ||
| Licensed practical nurses | 0.59 | ||
| Nursing staff turnover (share who left in a year) | 56.0% | 45.1% | 45.8% |
| Registered nurse turnover | 54.2% | 45.4% | 42.9% |
| Administrators who left | 1 |
CMS expects 4.61 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 3.93 on weekdays and 3.42 on weekends, 13% 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 4.01 in April to June 2025 to 3.78 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 | 3.78 | 0.95 | 3.93 | 3.42 | 0.0% | 0 of 90 | 81 |
| Oct to Dec 2025 | 3.94 | 0.94 | 4.13 | 3.44 | 0.0% | 0 of 92 | 78 |
| Jul to Sep 2025 | 4.12 | 1.03 | 4.36 | 3.51 | 0.0% | 0 of 92 | 78 |
| Apr to Jun 2025 | 4.01 | 1.17 | 4.26 | 3.41 | 0.0% | 0 of 91 | 72 |
| 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. If you work here, your report helps start one.
| 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 | 9.9 | 14.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.4 | 1.0 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.0 | 1.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 3.9 | 2.6 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.9 | 1.3 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 16.9 | 17.2 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 3.7 | 4.3 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 0.7 | 15.1 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 21.1 | 19.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 10.5 | 13.4 | 12.0 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Snohomish 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 (53.0% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
53.0% 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. 105 eligible stays.
11.2% 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. 103 eligible stays.
6.5% 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. 53 eligible stays.
63.9% 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. 61 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. 80 residents counted.
0.0% 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. 80 residents counted.
98.0% 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. 51 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: SNOHOMISH OF CASCADIA LLC. CMS links this home to Cascadia Healthcare, a group of 47 nursing homes averaging 3.1 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Cascadia Washington Operations LLC | Direct ownership interest | Organization | 04/01/2022 | |
| Cascadia Hc Group LLC | Indirect ownership interest | Organization | 06/05/2025 | |
| Cascadia Healthcare LLC | Indirect ownership interest | Organization | 04/01/2022 | |
| Cascadia Holdco LLC | Indirect ownership interest | Organization | 06/05/2025 | |
| Hammond, Owen | Indirect ownership interest | Individual | 12/08/2021 | |
| Laforte, Stephen | Indirect ownership interest | Individual | 06/05/2025 | |
| Nelson, Timothy | Indirect ownership interest | Individual | 06/05/2025 | |
| Snohomish 800 Realty LLC | 5% or greater security interest | Organization | 06/05/2025 | |
| White Oak Healthcare Finance LLC | 5% or greater security interest | Organization | 08/11/2022 | |
| Cascadia Services LLC | Operational/managerial control | Organization | 12/02/2021 | |
| Bhumkar, Nishita | Operational/managerial control | Individual | 12/02/2021 | |
| Hammond, Owen | Operational/managerial control | Individual | 12/08/2021 | |
| Jackson, Zachary | Operational/managerial control | Individual | 06/24/2025 | |
| Laforte, Stephen | Operational/managerial control | Individual | 06/05/2025 | |
| Nelson, Timothy | Operational/managerial control | Individual | 06/05/2025 | |
| Cascadia Services LLC | Adp of the SNF | Organization | 02/12/2025 | |
| Snohomish 800 Realty LLC | Adp of the SNF | Organization | 06/05/2025 | |
| Bhumkar, Nishita | Adp of the SNF | Individual | 07/16/2025 | |
| Jackson, Zachary | Adp of the SNF | Individual | 07/16/2025 |
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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