01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-03-27 | 13 | 2025-03-27 | 9 |
| Cycle 2 | 2024-02-06 | 31 | 2024-02-06 | 25 |
| Cycle 3 | 2022-10-12 | 12 | 2022-10-12 | 1 |
CMS CCN 5050042026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Avamere Rehabilitation Of Issaquah
805 Front Street · Issaquah, WA 98027 · King County
Certified beds140CMS provider file
Recent citation rows91current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
91 rows in the current release
3 rows carry G–L scope/severity codes; 1 carry J–L. 17 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-03-27 · FIREE0015Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREE0018Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish procedures for tracking staff and patients during an emergency.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREE0023Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures for medical documentation.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · HEALTHF0569Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0585Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0623Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0645Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0678Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0679Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-05-14 · complaint2025-03-27 · HEALTHF0770Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Provide timely, quality laboratory services/tests to meet the needs of residents.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-05-142025-03-27 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREK0920Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2025-04-252025-03-27 · FIREK0921Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Correction field: Deficient, Provider has date of correction · 2025-04-252024-02-06 · FIREE0034Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide a means of sharing information on occupancy/needs.
Correction field: Deficient, Provider has date of correction · 2024-02-222024-02-06 · FIREE0035Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide family notifications of emergency plan.
Correction field: Deficient, Provider has date of correction · 2024-02-2203 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-02-06 | Fine | $48,663 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ARISO LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2023
- ARI OPERATIONS, LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2023
- AVAMERE GROUP LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2023
- KARL RICKARD MILLER JR REVOCABLE TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2023
- MILLER, KARLIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2023
- MIDCAP FINCO LLCOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 02/01/2023
- CAVALLO, GLENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- FEAKIN, CODYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- FUNDERBERG, MICHELLEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- GARCIA, ROBERTOIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/01/2026
- INSKEEP, TODDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- KOFSTAD, MARYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- REID, MISTYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- STAPLES, CAROLYNIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/01/2025
- STRUNK, COLBYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- VANDERZANDEN, CARRIEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2025
- AVAMERE HEALTH SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2023
- AVAMERE SKILLED ADVISORS LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2023
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.08per resident day
RN hours0.59per resident day
Weekend nurse hours3.65per resident day
Staff turnover42.4%CMS reported field
06 / LOCAL RECORDS
Open the Issaquah ledger →