Above average — CMS composite of the measures below.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Briarwood At Timber Ridge during CMS and state inspections, most recent first.
Food items were found open, unlabeled, and undated in dry storage, the walk-in refrigerator, and the freezer, including sauces, nuts, cheeses, soybean paste, meat, tortellini, salami, and resident steaks. In the kitchen, a dirty fan was blowing near air-drying dishes, two ice machines had dirt build-up with no clear cleaning oversight, and multiple trash bins used during food prep were left uncovered.
Kitchen equipment was not kept in safe operating condition. The main dishwasher failed to reach required wash and rinse temps during observed cycles, a test plate showed improper sanitation, and the temperature log had no entry confirming safe operation. The walk-in refrigerator used for desserts repeatedly logged temps above 40 F and was observed holding food at 43 F, while the freezer thermostat remained above safe limits and was observed externally wired and improperly positioned.
Incomplete ADL Care Plans: Two residents had care plans that did not match assessed needs. One resident's plan omitted substantial/maximal grooming assistance despite MDS findings and visible poor grooming, while another resident's plan omitted partial/moderate eating assistance and lower partial denture care despite MDS, dental notes, and observation showing one-on-one feeding support and the denture left out.
Care plans were not revised to reflect current resident status for three residents. One resident’s wound care plan still listed non-weight-bearing and boot instructions after the wound had healed, another resident with severe cognitive impairment and max assist needs for eating was only care planned for set-up assistance, and a third resident’s plan contained conflicting left arm restrictions after a fall-related collarbone injury and later discontinuation of sling use.
Pain orders lacked clear parameters and non-pharm interventions were not documented for two residents with pain-related needs, while another resident’s boot and weight-bearing instructions were not clarified in the orders or Kardex. In addition, a resident receiving dialysis did not have post-dialysis vital signs monitored as ordered, with staff documenting vitals at the wrong time instead of on return from the dialysis center.
Failure to Provide Required ADL Assistance: The facility did not ensure residents dependent on staff for ADLs received needed help with compression stockings, meals, grooming, and dentures. A resident with lower-extremity swelling was repeatedly observed without ordered compression stockings, two residents needing eating assistance were left without adequate help during meals, and another resident needing grooming support was observed with unkempt hair, facial hair, and flakes on clothing. A resident who required denture assistance was observed eating without the lower partial denture in place, and staff were unsure whether it had been inserted.
The facility failed to provide appropriate care for three residents. A resident with diabetes had insulin orders but no PRN orders for hypo/hyperglycemia management, no emergency glucagon order, and no ordered Ha1C monitoring every 6 months despite elevated results. Another resident at risk for skin breakdown had an open leg area and red, mushy heels, but skin prevention measures were not in place as expected. A third resident with constipation and bowel incontinence did not receive the facility bowel protocol when no BM occurred for 2 days, and staff did not document evaluation or notify the provider.
A facility failed to ensure monthly pharmacist MRRs were completed and that recommendations were reviewed and acted upon for two residents. One resident had dementia, anxiety, depression, and use of antipsychotic, antidepressant, and anticonvulsant meds; the other had HF, HTN, DM, edema, and kidney disease with injectable diabetes meds and diuretic-type treatment. The pharmacist’s recommendations were delayed or not documented as completed on time, and one resident had no indication of an October MRR in the facility binder.
Incomplete medication review documentation: The facility failed to keep complete medical records for two residents receiving psychotropic medications. Records lacked physician documentation and scanned interdisciplinary forms supporting GDR decisions for an antianxiety medication in one resident and for antidepressant and antipsychotic medications in another resident, even though staff said the physician rationale existed in separate files.
The facility failed to provide two residents with the required written notices, including appeal rights, at the time of transfer to an acute care hospital. The facility's policy mandated that such notices be given, but records for both residents lacked the necessary documentation. Staff interviews confirmed the omission, revealing that the charge nurses responsible for completing the transfer paperwork did not include the appeal rights in the packets provided to the residents.
The facility failed to monitor residents on anticoagulants for side effects and did not properly manage edema in a resident. Several residents on anticoagulants were not monitored for bleeding, and a resident with edema was not consistently using compression stockings as recommended. Documentation and monitoring were insufficient, leading to potential health risks.
The facility failed to ensure a safe environment by not activating bathroom door chime alarms for two residents with dementia, leaving a maintenance cart with tools and chemicals unsupervised, and not securing storage and kitchen pantry doors. These actions placed residents at risk for accidents and injuries.
The facility failed to implement comprehensive care plans for three residents, leading to unmet care needs. A resident with dementia did not consistently receive prescribed compression stockings. Another resident with a stroke had outdated care plans and inconsistent stocking application. A third resident with a lung infection lacked a care plan for long-term antibiotic use.
The facility failed to follow physician's orders and medication parameters for three residents, leading to medication errors and unclarified duplicate orders. A resident with high blood pressure received medications outside prescribed parameters multiple times, while another had duplicate laxative orders unclarified. Additionally, a resident received a laxative despite having bowel movements documented, contrary to the order. These issues were acknowledged by the DON and MDS Coordinator.
Food Storage and Kitchen Sanitation Deficiencies
Penalty
Summary
Food was not stored and prepared in accordance with professional standards of safety. During observation of dry storage, six bottles of assorted sauces and cooking condiments and one bottle of chocolate syrup were open but undated, and several had dried-up drips along the sides of the bottle caps. Two packages of dry cashews and walnuts were left open and uncovered. In the walk-in refrigerator, three kinds of partially cut-up cheeses and one package of soybean paste were opened and undated. In the freezer, one package of ground meat, one package of frozen pasta tortellini, one package of freezer-burned salami, and two individually wrapped steak slices inside a grocery bag were open or unlabeled and undated. Staff G and Staff E confirmed the items were not labeled and dated as required by facility policy. The kitchen also had sanitation issues involving equipment and waste containers. A stand-up fan placed on top of a metal table by the dishwasher was turned on, dirty, and heavily covered with black dust build-up on the blades and outer mesh cover while dishes and utensils were air-drying nearby. Two ice machines in the main kitchen had brownish dirt build-up inside the upper chamber, and staff were unsure who was responsible for monitoring their cleanliness; the facility dietician’s log reviewed only covered the ice machine on the skilled nursing unit. Five kitchen garbage and trash bins in active use during food preparation were observed without lids or covers, and Staff G stated lids were on order.
Kitchen Equipment Not Maintained at Safe Operating Temperatures
Penalty
Summary
Essential kitchen equipment was not maintained in safe operating condition, including the main kitchen dishwasher, the walk-in refrigerator used for bakery desserts, and the freezer thermostat. The facility policy required refrigeration and food temperatures to be monitored at designated intervals and dishwashing machines to be operated according to manufacturer instructions with preventative maintenance in place. The manufacturer instructions for the high-temperature conveyor dish machine specified wash temperatures of 150-160 F and final rinse temperatures of 180-195 F. During observation and interview, the main kitchen dishwasher did not reach the required temperatures during two actual run cycles. One cycle showed a wash temperature of 145 F and a rinse temperature of 140 F, and a second cycle showed both wash and rinse temperatures at 148 F. A test plate placed in the machine showed a gray color indicating it was not cleaned and sanitized properly. The December 2025 dishwashing temperature log had no monitoring completed on 12/10/2025 to confirm safe operating temperatures. A third-party preventative maintenance summary dated 12/11/2025 stated the dishwasher was malfunctioning, would not fill or heat, and needed parts replaced. Staff later stated the three-compartment sink was being used after the malfunction was identified. The walk-in refrigerator for desserts had repeated temperature readings above 40 F on the daily log, including 47 F, 42 F, and 41 F, and observation showed dessert items being placed inside while the thermostat read 43 F. Staff stated the refrigerator was broken and should not be in use. The freezer thermostat also remained outside safe parameters, with logged temperatures above 0 F and an observed reading of 2.5 F; the device was externally wired, wedged between the freezer door and door jamb, and threaded inside the freezer. Staff stated the freezer had been opened and was probably defrosting, and later stated replacement of the thermostat device was in progress.
Incomplete ADL Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive care plans that accurately reflected the care needs of 2 residents reviewed for care planning. For one resident, the admission MDS dated 10/21/2025 assessed clear speech, impaired memory, and a need for substantial/maximal assistance with grooming/personal hygiene, but the revised ADL care plan dated 10/20/2025 did not include that level of grooming assistance. On 12/10/2025, the resident was observed with facial hair/stubbles, bushy eyebrows, long unkempt hair, and white flakes covering both shoulders and the upper chest of the shirt. The DON reviewed the care plan and stated the resident's need for grooming assistance should have been captured but was not. For the second resident, the quarterly MDS dated 10/01/2025 assessed clear speech, impaired memory, partial/moderate assistance with eating, and dependence on staff for oral hygiene. A dental visit note dated 11/24/2025 documented a lower removable partial denture and the need for staff assistance with daily denture removal and cleaning. The revised ADL care plan dated 01/30/2024 did not include the resident's partial/moderate eating assistance or the lower partial denture and related staff assistance. On 12/12/2025, the resident was observed receiving one-on-one eating assistance and was not wearing the lower partial denture, which was left in a cup by the sink. The DON stated both the eating assistance level and current denture use should have been captured in the care plan but were not.
Care Plans Not Updated to Match Current Resident Needs
Penalty
Summary
The facility failed to keep care plans updated and revised to reflect residents’ current conditions and person-centered care for three residents whose records were reviewed. The facility policy stated care plans would be revised when information about the resident or the resident’s condition changed. Surveyors found that the care plans for Resident 3, Resident 14, and Resident 6 did not match the residents’ current needs and treatment status. Resident 3’s pressure wound care plan, revised 05/30/2025, directed staff that the resident could not bear weight on the left lower extremity and to check the left foot every shift while the resident wore a hard boot. Observations showed the resident in a wheelchair with a hard boot on the left lower leg, and the collateral contact stated the resident wore the boot with a regular shoe on the other foot and could bear some weight on the left leg. Staff Q stated the wound had healed about four weeks earlier and the resident was now able to bear weight on the left foot, but the care plan had not been updated to reflect the current weight-bearing status or provide directions for managing the boot. Resident 14’s MDS showed severe cognitive impairment and substantial/maximal assistance needed with eating, but the care plan revised 08/12/2025 stated the resident only needed set-up assistance with meals in the dining room. During lunch observation, the resident sat at the table, looked around, fell asleep, and staff did not provide cueing or eating assistance until the surveyor intervened and a CNA cut up the food and gave the first bite. Resident 6’s records showed a fall with a major injury during the assessment period, including a left collarbone fracture and hospital discharge with an arm sling and left arm non-weight-bearing restrictions. The care plan contained conflicting weight-bearing restrictions and still included sling-related interventions even though physician orders later discontinued the sling and non-weight-bearing restriction, while observations showed the resident not wearing a sling and using the left arm during meals.
Pain Orders, Boot Instructions, and Post-Dialysis Monitoring Were Not Followed
Penalty
Summary
The facility failed to ensure pain management orders and non-pharmaceutical interventions were carried out as documented for Resident 8 and Resident 3. Resident 8 had diagnoses including an upper arm fracture, pain, and muscle spasms, and was assessed with occasional pain that interfered with therapy and activities of daily living. The resident’s care plan directed staff to offer pain medications and encourage non-pharmacological measures such as repositioning and relaxation therapy, but the December 2025 MAR showed an OTC pain medication order with no pain scale or parameters, and a narcotic pain medication order for moderate to severe pain. The MAR also showed the narcotic was given for pain rated 4 out of 10. The TAR listed eight non-pharmacological interventions to offer, but did not show what interventions were offered or which were effective. Resident 8 stated they had left shoulder pain and anxiety about falling again. Resident 3 had diagnoses including non-traumatic brain dysfunction, dementia, and anxiety, and the quarterly MDS showed no current pain. The pain care plan directed staff to assess pain every shift using a pain scale, attempt non-pharmacological methods, and offer and document pain medications. The December 2025 MAR showed an OTC pain medication order every four hours as needed and a narcotic pain medication order every four hours for moderate to severe pain, but the orders did not include parameters directing which medication to give for specific pain levels. The TAR again listed eight non-pharmacological interventions without documenting what was offered or what was effective. During interview, staff stated the pain medication orders should have parameters and that non-pharmacological interventions should be attempted and documented before giving pain medication. The facility also failed to clarify physician orders and follow post-dialysis orders. Resident 3 was observed in a wheelchair with a hard boot on the left lower leg, while the Kardex identified the resident as non-weight bearing to the left lower extremity. The physician orders directed staff to assess the left foot condition while wearing the crow boot and monitor for skin impairment, but there was no order stating whether the resident could bear weight, remove the boot, how to manage the boot during showers, what to do if the bandage was dislodged or soiled, or any treatment orders as needed. For Resident 18, who had kidney disease and received dialysis three times weekly, the TAR showed orders for pre- and post-dialysis assessments, but staff documented vitals on the TAR at 11:00 PM on non-dialysis nights instead of assessing the resident upon return from dialysis on Monday, Wednesday, and Friday. The DON stated staff were supposed to monitor vital signs upon the resident’s return from the dialysis center.
Failure to Provide Required ADL Assistance
Penalty
Summary
The facility failed to ensure residents who were dependent on staff for assistance with ADLs received the assistance they required. The report identified failures involving compression stockings, eating assistance, grooming/personal hygiene, and denture assistance for four residents. The facility policy stated that care and services would be provided to residents unable to carry out ADLs independently, including support with hygiene and dining. Resident 3 had swelling in both lower legs and a care plan directing staff to apply knee-high compression stockings in the morning and remove them at night. However, on multiple observations the resident was seen in a wheelchair with a hard boot on the left lower leg and no compression stockings on either leg. The resident’s collateral contact stated the resident was not supposed to wear compression stockings because of a left foot wound, while staff later stated the wound had healed three to four weeks earlier and that there was an active physician order and care plan for compression stockings. Staff also observed pitting swelling in the ankles. Resident 14 had severe cognitive impairment and required substantial/maximal assistance with eating, but the care plan only showed meal setup assistance. During lunch and breakfast observations, the resident sat with meals in front of them, fell asleep, and did not eat while staff did not assist or offer assistance. Resident 26 was assessed as needing substantial/maximal assistance with dressing, grooming, and personal hygiene, but was observed with facial hair/stubble, bushy eyebrows, long unkempt hair, and white flakes on the shirt; the resident stated staff did not help with shaving and wanted assistance. Resident 15 required partial/moderate assistance with eating and was dependent on staff for oral hygiene because they could not insert and remove dentures, yet during a meal the resident was observed eating without the lower partial denture in place, which was left in a cup by the sink, and staff were unsure whether the denture was being worn.
Diabetes monitoring, skin prevention, and bowel protocol failures
Penalty
Summary
The facility failed to ensure Resident 5, who had diabetes, heart failure, and kidney disease and was receiving daily insulin, had appropriate monitoring and orders in place for emergent blood sugar changes. Resident 5’s care plan directed staff to monitor for signs and symptoms of low or high blood sugar and to monitor Ha1C as ordered, but the physician orders only directed staff to hold insulin if blood sugar was below 70 or greater than 350. No orders were found for as-needed management of low or high blood sugar, no emergency medication orders such as glucagon were present, and no physician order was found for Ha1C testing every six months. The record showed one Ha1C result with abnormally high values and no follow-up Ha1C testing every six months. Resident 5 stated they were having finger sticks five times a day and sometimes their fingers hurt. The facility also failed to implement skin preventative measures for Resident 8. Resident 8’s MDS showed no current skin conditions, but a Braden Scale identified the resident as at risk for skin issues due to occasional moisture, severely limited walking ability, and friction and shearing concerns in bed. The care plan directed staff to educate the resident and representative on factors to maintain skin integrity and to use pressure relieving surfaces. During observation, Resident 8 was found in bed with a dry circular scabbed area and a small open area on the leg, and later the heels were observed to be red, soft, dimpled, and mushy, with a slight discoloration at the center of the right heel and pain when pressed. Staff stated they were not sure how the open area was missed on admission and weekly skin checks, and that skin preventative measures should have been in place on the care plan and Kardex. The facility failed to follow the bowel protocol for Resident 7, who had impaired memory, frequent bowel incontinence, constipation, and required substantial to maximal assistance with toileting. The bowel care plan directed nursing staff to administer bowel medications per facility protocol if the resident did not have a bowel movement for two days, and the pain care plan noted the resident was taking pain medications and should be monitored for constipation. Records showed multiple periods in November when Resident 7 had no bowel movement for two days, but progress notes did not show nursing staff evaluated the bowel pattern or notified the physician for further evaluation or treatment. The MAR showed the resident received stool bulk-forming medication every two days, but no additional bowel medications were administered per the facility protocol during those periods. When observed, Resident 7 was bent over in bed, restless and uncomfortable, and stated they felt the urge to have a bowel movement but could not.
Delayed and Missed Pharmacist Medication Regimen Reviews
Penalty
Summary
The facility failed to ensure that a licensed pharmacist’s monthly Medication Regimen Reviews (MRRs) were completed monthly and that pharmacist recommendations were reviewed and acted upon for 2 of 5 residents reviewed for unnecessary medications. The facility’s policy stated that the pharmacist would provide the DON and Medical Director with a written, signed, and dated report listing irregularities and recommendations for their solutions. The report cited WAC 388-97-1300(4)(c) as the applicable reference. Resident 3’s quarterly MDS showed diagnoses including non-traumatic brain dysfunction, dementia, anxiety, and depression, and indicated use of antipsychotics, antidepressants, and anticonvulsants. The medical record showed the pharmacist completed MRRs for 10/01/2025-10/31/2025 and 11/01/2025-11/30/2025 and made medication recommendations on 10/19/2025 and 11/10/2025, but facility staff did not implement them until 17 days later and 21 days later, respectively. Resident 5’s quarterly MDS showed diagnoses including heart failure, high blood pressure, diabetes, swelling, and kidney disease, with use of injectable diabetes medications and medications for swelling. A facility binder showed no indication that Resident 5’s October 2025 MRR occurred, and the medical record showed pharmacist recommendations from the 09/01/2025-09/30/2025 and 11/01/2025-11/30/2025 MRRs were not implemented until 16 days later and 21 days later, respectively.
Incomplete Medication Review Documentation
Penalty
Summary
The facility failed to maintain complete and accurate medical records for 2 residents by not including interdisciplinary team documentation related to psychotropic medication review and Gradual Dose Reduction (GDR) decisions. For Resident 34, the record showed diagnoses of anxiety and depression and use of an antianxiety medication three times daily and an antidepressant every morning. A social services progress note summarized psychotropic medications and indicated a GDR recommendation for the antianxiety medication was rejected, but the resident’s comprehensive record did not contain physician progress notes, scanned physician documents, or pharmacy recommendations documenting the physician’s rationale for that rejection. Staff C stated the interdisciplinary team completed a Behavior Monitor/Medication Management form and that the signed physician rationale existed in personal files, but it had not been scanned into the resident’s record. For Resident 3, the record showed diagnoses including non-traumatic brain dysfunction, dementia, anxiety, and depression, with use of an antidepressant and an antipsychotic medication. The care plan stated the antidepressant GDR was contraindicated and the dose had remained the same for the last year, and it also stated the antipsychotic GDR was rejected. However, the comprehensive medical record did not contain physician progress notes, scanned physician documents, or pharmacy recommendations documenting the physician’s rationale for rejecting the GDR for either medication. Staff C stated the interdisciplinary team discussed the medications and produced a Behavior Monitor/Medication Management form showing the physician agreed a GDR for the antipsychotic was not recommended, but the form did not address the physician’s rationale for not performing a GDR for the antidepressant medication.
Failure to Provide Required Transfer Notices
Penalty
Summary
The facility failed to ensure that residents received the required written notices at the time of transfer or discharge, specifically for two residents who were transferred to an acute care hospital. The facility's policy required that a notice of transfer be provided as soon as practicable, including the reason, effective date, location, and an explanation of the resident's rights for transfer. However, for both residents reviewed, the records lacked the reverse side of the Notice of Emergency Transfer form, which contained information on appeal rights. This omission was identified during a review of the residents' records and confirmed by staff interviews. Resident 30 was transferred to an acute care hospital with an anticipated return, but the appeal rights were not documented in their records. Similarly, Resident 43 was transferred under the same circumstances, and their records also lacked the appeal rights documentation. Interviews with the Social Services Director and a Licensed Practical Nurse revealed that the charge nurses were responsible for completing the transfer paperwork, which should have included the appeal rights. However, the required information was missing from the packets provided to the residents upon transfer, as confirmed by the staff during the review.
Inadequate Monitoring of Anticoagulant Use and Edema Management
Penalty
Summary
The facility failed to ensure that five residents received necessary care and services in accordance with professional standards of practice. Specifically, the facility did not adequately monitor residents taking anticoagulant medications for potential complications such as excessive bruising, bleeding, or bloody urine. Residents 33, 5, 26, and 29 were all on anticoagulant medications, yet there were significant lapses in monitoring for adverse side effects. For instance, Resident 33 experienced frequent nosebleeds and had a history of gastrointestinal bleeding, but monitoring for bleeding was only ordered 13 months after the initial anticoagulant prescription. Similarly, Residents 5, 26, and 29 had no documented instructions for monitoring adverse effects until months after starting their medications. Additionally, the facility failed to properly assess, monitor, and apply compression stockings for Resident 34, who had edema. Despite recommendations for the use of compression stockings to manage swelling in the lower legs, observations showed that Resident 34 was not wearing them. The facility's records lacked consistent documentation of the resident's edema status, and there was no comprehensive care plan addressing the resident's heart failure and related edema treatment. Staff interviews revealed an expectation for regular monitoring and documentation, which was not met. These deficiencies in monitoring and documentation placed residents at risk for delays in treatment and potential declines in health. The facility's policies on anticoagulation and edema management were not followed, leading to inadequate care for the affected residents.
Failure to Maintain Safe Environment and Supervise Residents
Penalty
Summary
The facility failed to maintain a safe environment free from accident hazards for two residents, identified as Resident 7 and Resident 26, among a sample of 12. The deficiencies included the failure to activate bathroom door chime alarms for these residents, which were intended to alert staff when the residents attempted to use the bathroom without assistance. Observations revealed that the bathroom doors for both residents were left open, and the alarms were not functioning, despite care plans and physician orders requiring their use. Resident 7, who had severe memory impairment and a history of falls, was observed multiple times with the bathroom door open and the alarm disengaged. Similarly, Resident 26, who also had dementia and a history of falls, was observed entering the bathroom without the alarm triggering. Additional hazards were identified in the facility's common areas. A maintenance cart containing tools and chemicals was left unsupervised in a hallway accessible to residents, posing a risk, especially to those with dementia. The cart included a drill and a bottle of drain opening compound. Furthermore, a storage room near the nurse's station was found unlocked, containing supplies and bottles of a liquid medication disposal system with warning labels indicating potential harm if ingested. The kitchen pantry door was also observed propped open without staff present, despite having a keypad lock system. Interviews with staff, including the MDS Coordinator, Director of Nursing, and Administrator, confirmed that these conditions were not in compliance with the facility's safety protocols. Staff acknowledged the risks posed by unsupervised tools and chemicals, as well as the necessity of keeping storage areas and the kitchen pantry secured. The failure to adhere to care plan interventions and safety protocols placed residents at risk for accidents and injuries.
Failure to Implement Comprehensive Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive care plans for three residents, leading to unmet care needs. Resident 7, with severe dementia and requiring assistance for dressing, had a care plan directing staff to apply compression stockings daily. However, observations showed inconsistencies in following this directive, with the resident not wearing the stockings as prescribed. Staff interviews confirmed the expectation to adhere to care plan interventions, which was not met in this case. Resident 34, with a history of stroke and on anticoagulant medication, also had a care plan for compression stockings that was not consistently followed. Additionally, an outdated care plan related to COVID-19 was not updated to reflect the resident's current status. Resident 33, with mild cognitive impairment and a lung infection, lacked a care plan addressing their antibiotic treatment, which was determined to be long-term. The absence of specific goals and interventions for this treatment was noted, highlighting a gap in the care planning process.
Medication Administration and Order Clarification Deficiencies
Penalty
Summary
The facility failed to ensure that physician's orders were followed, medications were administered within ordered parameters, and physician orders were clarified as needed for three residents. Resident 38, who had multiple medically complex diagnoses including high blood pressure, received medications outside of the prescribed parameters on multiple occasions across August, September, and October 2024. Specifically, Medication B was administered outside of the parameters on eight occasions in August, five in September, and nine in October, while Medications A and C were also given outside of parameters on one occasion each in October. The Director of Nursing acknowledged the expectation for staff to adhere to medication parameters as ordered by the provider. Resident 96 had duplicate orders for a laxative suppository to be given as needed for constipation, which were not clarified, as noted by the MDS Coordinator. Additionally, Resident 34 received a liquid laxative on September 6, 2024, despite having two bowel movements documented the previous day, contrary to the order to administer the medication only if no bowel movement occurred in two days. The MDS Coordinator confirmed the expectation for staff to follow orders and administer medications as prescribed. These failures placed residents at risk for medication errors, delayed treatment, and adverse outcomes.
What surveyors are citing around you — mapped
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Illustrative
What surveyors actually found near you
We read the 999 citations issued within 25 miles in the last 12 months — including the 2 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Issaquah
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Avamere Rehabilitation Of Issaquah | 1.5 mi | ★★★★★ | 0 | 0 |
| Marianwood Health And Rehabilitation | 3.3 mi | ★★★★★ | 22 | 0 |
| Covenant Shores Health Center | 7.4 mi | ★★★★★ | 25 | 0 |
| Bellevue Post Acute | 7.5 mi | ★★★★★ | 66 | 0 |
| Renton Health & Rehabilitation | 7.8 mi | ★★★★★ | 28 | 0 |
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