01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-16 | 14 | 2026-01-16 | 8 |
| Cycle 2 | 2024-10-04 | 34 | 2024-10-04 | 8 |
| Cycle 3 | 2023-08-09 | 9 | 2023-08-09 | 7 |
CMS CCN 5053442026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Canterbury House
502 29Th Street Southeast · Auburn, WA 98002 · King County
Certified beds100CMS provider file
Recent citation rows80current 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
80 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 16 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-16 · 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 · 2026-02-052026-01-16 · FIREE0020Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures including evacuation.
Correction field: Deficient, Provider has date of correction · 2026-01-292026-01-16 · HEALTHF0565Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · HEALTHF0628Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · HEALTHF0636Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · 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 · 2026-02-182026-01-16 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · HEALTHF0658Severity E · pattern; 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 · 2026-02-182026-01-16 · 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 · 2026-02-182026-01-16 · HEALTHF0688Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · 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 · 2026-02-182026-01-16 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · HEALTHF0849Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · 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 · 2026-02-182026-01-16 · HEALTHF0908Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Keep all essential equipment working safely.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · HEALTHF0947Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-16 · FIREK0222Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-02-052026-01-16 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2026-01-142026-01-16 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-01-152026-01-16 · FIREK0372Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2026-03-032026-01-16 · FIREK0374Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2026-03-032026-01-16 · 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 · 2026-02-052024-12-12 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2025-01-14 · complaint2024-12-12 · HEALTHF0607Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2025-01-14 · complaint03 / 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 |
|---|---|---|---|
| 2024-02-02 | Fine | $68,159 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PACIFIC NORTHWEST SNF OPERATIONS HOLDINGS (WA) LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- CH PACIFIC NORTHWEST HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- PACIFIC NORTHWEST SNF OPERATIONS HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- WITZCORP GLOBAL LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- HERZKA, YISROELIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- YENOWITZ, YITZCHOKIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- BAYHON, MARISSAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 08/31/2023
- ODENTHAL, JASONIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 08/31/2023
- COUVE FINANCIAL SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- COUVE HEALTHCARE CONSULTING LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- PACIFIC NORTHWEST OPCO MANAGEMENT LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- WASHINGTON SNF CONSULTING LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- ODENTHAL, JASONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- PANLASIGUI, LEONICOIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- PIERCE, MARYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- SPIELMAN, SHIMONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- WRIGHT, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- YENOWITZ, YITZCHOKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
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 hours3.85per resident day
RN hours0.70per resident day
Weekend nurse hours3.54per resident day
Staff turnover35.8%CMS reported field