Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Avalon Healthcare Bellingham during CMS and state inspections, most recent first.
A resident with impaired mobility and sensation developed an unstageable, later Stage 4, sacral pressure ulcer that became infected and required hospitalization after staff failed to consistently reposition, monitor, and implement pressure offloading interventions as care planned. Documentation and staff interviews revealed inconsistencies in care delivery, lack of timely updates to the care plan, and insufficient monitoring, despite the resident being identified as at risk for pressure ulcers.
A resident with multiple diagnoses was transferred to the hospital without the facility notifying their Guardian of abnormal lab values or the transfer. The Guardian was informed by hospital staff instead. An LPN attempted to contact the Guardian but did not leave a message or use the on-call option. The DON confirmed the expectation for communication of such changes.
The facility's activity program was directed by an unqualified professional, leading to low resident engagement and dissatisfaction. The Recreation Director lacked necessary certification, and the administrator acknowledged the issue without an active plan for correction. Residents reported boredom and insufficient engagement, with observations showing minimal participation in scheduled activities.
The facility failed to provide care and treatment according to professional standards for several residents, leading to unmet care needs and potential medical complications. A resident with heart failure did not receive required weights and was observed without a necessary bandage. Another resident with kidney disease missed lab tests due to a change in lab providers. A resident on Depakote experienced issues with medication administration and lab draws. A resident with pressure ulcers did not receive consistent nutritional support, and a resident with chronic conditions refused TED hose without alternatives offered.
A facility failed to ensure proper delegation of resident rights for decision-making for a resident with severe cognitive impairment. The resident's care plan incorrectly listed a deceased family friend as the POA, while the daughter was the next of kin. Despite the resident's inability to make informed decisions, their signature appeared on legal documents. Staff interviews revealed confusion about the process for determining decision-making capacity and obtaining informed consent.
The facility failed to develop comprehensive care plans for residents, leading to deficiencies in addressing specific needs such as congestive heart failure, discharge planning, and therapy goals. Residents expressed stress and confusion due to the lack of communication and documentation regarding their care and discharge plans.
A facility failed to assist a resident with ADLs, including grooming and clothing changes, despite the resident's need for assistance due to cognitive and physical impairments. Observations showed the resident wore the same soiled clothing and had unshaven facial hair over several days. Staff interviews confirmed the resident did not refuse care, indicating a lack of adherence to the care plan.
A resident with a history of stroke and post-polio syndrome, who was cognitively intact and dependent on staff for toileting, experienced extended waiting times for assistance despite a specific toileting schedule. Observations showed repeated delays and inadequate response to call lights, with staff turning off the call light without providing care. Interviews revealed a lack of communication and coordination among staff, leading to the resident's unmet toileting needs.
Two residents experienced avoidable accidents due to the facility's failure to follow individualized care plans and provide adequate supervision. One resident, with a history of stroke, fell from bed and sustained a head injury when a CNA assisted them alone, contrary to the care plan. Another resident, with hemiplegia, left the facility unsupervised and was found by police at a nearby hospital. Investigations revealed staff did not adhere to care plans, contributing to these incidents.
A facility failed to maintain a resident's confidentiality when an LPN provided a care plan to an unauthorized visitor. The resident's POA confirmed that the visitor was not authorized to receive any private information. This breach violated the facility's policy on privacy and confidentiality, risking the resident's right to privacy and preference.
The facility failed to thoroughly investigate incidents involving two residents. One resident, with a history of stroke, fell due to a CNA not following the care plan requiring two-person assistance. Another resident, with hemiplegia, eloped from the facility, and the investigation did not assess the care plan for supervision needs. The DNS confirmed the expectation for staff to follow care plans, but investigations were insufficient.
Failure to Prevent and Manage Pressure Ulcer Resulting in Harm
Penalty
Summary
The facility failed to consistently reposition, assess, and monitor skin integrity in a timely manner, and did not implement pressure offloading interventions to prevent the development of avoidable pressure ulcers for a resident identified as being at risk. The resident, who had a history of right hip fracture, spina bifida with impaired sensation, and required substantial assistance with mobility, was admitted without any pressure ulcers but was assessed as being at risk for their development. The care plan and Kardex indicated the need for staff assistance with turning and repositioning, as well as the use of pressure-relieving devices, but documentation and staff interviews revealed inconsistencies in the implementation and communication of these interventions. Despite being care planned for frequent repositioning and pressure relief, the resident developed an unstageable pressure ulcer on the sacrum, which was later diagnosed as a Stage 4 ulcer and became infected, requiring hospitalization. The resident and their family reported that after therapy services ended, staff did not assist with repositioning or provide reminders, and the resident, due to sensory loss, was unaware of the developing ulcer. Staff interviews indicated confusion regarding the level of assistance required for bed mobility and repositioning, and there was a lack of documentation regarding refusals of care or updates to the care plan in response to changes in the resident's condition or cooperation. Facility policy required individualized prevention and treatment plans, daily and weekly monitoring of pressure ulcers, and consistent implementation of interventions for residents at risk. However, the investigation found that the care plan was not consistently updated or followed, and there was insufficient documentation of care provided or resident refusals. The lack of timely and consistent interventions, monitoring, and communication among staff contributed to the development and worsening of the resident's pressure ulcer, resulting in significant harm.
Failure to Notify Resident's Guardian of Health Changes
Penalty
Summary
The facility failed to ensure proper notification of changes in health status for a resident, identified as Resident 1, who was admitted with diagnoses including schizoaffective disorder, encephalopathy, major depressive disorder, and anxiety. The medical record indicated that a Guardian was listed as the responsible party and emergency contact for Resident 1. However, the facility did not document any notifications made to the Guardian regarding abnormal lab values or the resident's transfer to the hospital on the specified date. Interviews revealed that the Guardian, referred to as CC1, was not informed by the facility about the resident's health changes or hospital transfer. Instead, CC1 learned of these events from hospital staff after the transfer. Staff C, an LPN and Unit Manager, admitted to attempting to contact the Guardian but did not leave a message or use the on-call option for emergencies. The Director of Nursing Services, Staff B, confirmed that it was expected for any changes in a resident's condition to be communicated to their representative, which did not occur in this instance.
Unqualified Activities Director and Low Resident Engagement
Penalty
Summary
The facility failed to ensure that its activity program was directed by a qualified activities professional, as required by regulations. The Recreation Director, Staff S, did not possess the necessary certification or qualifications for the role, having only an associate's degree in arts and science and prior experience in a memory care facility. This lack of qualification was acknowledged by the facility's administrator, Staff A, who admitted there was no active plan to rectify the situation. The deficiency was identified through interviews and observations that revealed low participation in scheduled activities and a lack of engagement with residents. Residents expressed dissatisfaction with the activities offered, citing boredom and a lack of personalized engagement. Observations showed minimal resident participation in scheduled activities, such as flower arranging and exercise groups, with only a small fraction of the 64 residents attending. Interviews with residents and staff highlighted issues such as insufficient one-to-one visits and a lack of interest in the activities provided. Staff S admitted to not addressing the low attendance and lack of interest in the Quality Assurance and Improvement Committee (QAPI) meeting, further contributing to the deficiency.
Deficiencies in Resident Care and Treatment
Penalty
Summary
The facility failed to provide care and treatment in accordance with professional standards for several residents, leading to unmet care needs and potential medical complications. Resident 6, diagnosed with congestive heart failure and cerebral infarction, did not receive the required weights on specified dates, and was observed without a necessary bandage on their nose despite documentation indicating otherwise. Staff interviews revealed a lack of adherence to procedures for obtaining weights and completing treatments as ordered. Resident 24, with a diagnosis of kidney disease, did not have required lab tests conducted as per physician orders. The facility's change in lab providers contributed to missed lab draws, and staff were unaware of these omissions until the survey. Similarly, Resident 29, who was prescribed Depakote for bipolar disorder, experienced issues with medication administration and lab draws, with staff failing to follow up on the resident's requests and the physician's orders for lab tests. Resident 53, suffering from a traumatic brain injury and pressure ulcers, did not receive consistent nutritional support as recommended by the dietician, and there was a lack of documentation for weekly wound specialist visits. The transition to a new company resulted in missing wound consultant notes, which were crucial for ongoing treatment and care planning. Additionally, Resident 23, with multiple chronic conditions, refused to wear TED hose due to discomfort, but no alternative solutions were offered, and staff failed to notify the provider of the resident's refusals.
Failure to Ensure Proper Delegation of Resident Rights for Decision-Making
Penalty
Summary
The facility failed to ensure proper delegation of resident rights for decision-making and informed consent for a resident with a traumatic brain injury. The resident, who was admitted with severe cognitive impairment, had no documented Advance Directives or decision-making hierarchy in their clinical record. The resident's care plan incorrectly listed a deceased family friend as the Power of Attorney (POA), while the resident's daughter was identified as the next of kin. Despite the resident's inability to make informed decisions, their signature appeared on several legal documents, including admission and arbitration agreements. Interviews with facility staff revealed a lack of clarity and understanding regarding the process for determining decision-making capacity and obtaining informed consent. Staff members were unsure of the procedures to follow when a resident lacked clear Advance Directives and decision-making capacity. The facility eventually provided a letter from the medical director stating the resident's incapacity to make healthcare decisions, but this was after the deficiency was identified.
Deficiencies in Care Plan Development and Implementation
Penalty
Summary
The facility failed to develop and implement comprehensive, person-centered care plans for several residents, leading to deficiencies in addressing their specific needs. Resident 6, who was admitted with chronic congestive heart failure, was observed to have persistent edema in both feet over several days. Despite these observations, the resident's care plan lacked specific interventions to address the congestive heart failure and associated edema, only including a general intervention to monitor and report signs of heart failure. For Resident 51, who was admitted with heart and liver problems and a history of alcohol use disorder, the care plan did not include a focus area for discharge planning, despite the resident's goal to return to the community. The resident expressed confusion and stress about the lack of a discharge plan, as they felt ready to go home and were no longer receiving therapy. Similarly, Resident 54, who was working with therapy to improve strength, also lacked a care plan focus on therapy goals or discharge planning, leaving the resident uncertain about their discharge timeline and future living arrangements. Resident 215, admitted with a left arm fracture, high blood pressure, and muscle weakness, also did not have a discharge plan included in their care plan, despite having an active discharge goal. The resident expressed stress over the lack of communication regarding their discharge plan. Interviews with staff revealed that the facility's process for updating care plans was lacking, with discharge planning not being adequately documented or communicated to residents, contributing to the deficiencies identified in the survey.
Failure to Assist Resident with ADLs
Penalty
Summary
The facility failed to assist a dependent resident, identified as Resident 6, with routine activities of daily living (ADLs), which included grooming and clothing changes. Resident 6, who was admitted with diagnoses such as stroke with hemiplegia, congestive heart failure, dementia, and depression, required supervision and assistance due to cognitive impairments and physical limitations. Despite the care plan directing staff to assist with clothing choices and grooming, including shaving twice a week, observations over several days showed that Resident 6 wore the same soiled clothing and had unshaven facial hair, indicating a lack of adherence to the care plan. Interviews with staff members revealed that Resident 6 did not refuse care, contradicting any assumption that the resident's condition was due to refusal. Staff members, including a Social Services staff, Nursing Assistant Certified (NAC), and the Director of Nursing, acknowledged the resident's need for assistance with ADLs and confirmed that the resident did not refuse care. The Director of Nursing was aware of the issue but noted that the care plan did not reflect any refusals of care, highlighting a gap in the facility's documentation and execution of the resident's care plan.
Failure to Provide Timely Toileting Assistance for a Resident
Penalty
Summary
The facility failed to provide necessary care and services to maintain continence for Resident 49, who was reviewed for incontinence. Resident 49, who was cognitively intact and dependent on staff for toileting needs, was admitted with diagnoses including stroke and post-polio syndrome. The resident's care plan required two-person maximum assistance using a Hoyer lift for toilet use and included a specific toileting schedule. However, the facility did not adhere to this schedule, leading to extended waiting times for toileting assistance. Observations and interviews revealed that Resident 49 often waited for an hour or more before receiving assistance, despite being continent and able to identify when they needed to urinate or have a bowel movement. The resident's representative, CC1, reported multiple complaints about the issue, noting that staff would turn off the call light, preventing the system from registering the waiting time. During one observation, the resident's call light was repeatedly turned on and off without providing the necessary care, and staff were delayed in assisting due to being occupied with other tasks. Staff interviews indicated a lack of communication and coordination in addressing Resident 49's toileting needs. Staff C, an LPN, acknowledged that the times on the Kardex were directed by CC1 but had not discussed specific time frames with them. Additionally, Staff C expected call lights to be answered within 10 minutes but had not conducted a bladder assessment for Resident 49. This lack of timely and coordinated care placed Resident 49 at risk for further decline in bowel and bladder function, as well as potential skin issues and emotional distress.
Failure to Follow Care Plans and Provide Supervision Leads to Resident Accidents
Penalty
Summary
The facility failed to provide adequate supervision and follow individualized care plans, resulting in avoidable accidents for two residents. Resident 1, who had a history of stroke and left-sided hemiparesis, required extensive assistance for bed mobility and incontinence care as per their care plan. However, a CNA assisted Resident 1 alone, contrary to the care plan's requirement for two-person assistance. During this unsupervised care, Resident 1 fell from the bed, sustaining a head injury that required hospitalization. Resident 2, diagnosed with hemiplegia and muscle weakness, required supervision and assistance for transfers and ambulation according to their care plan. Despite this, Resident 2 was able to leave the facility unsupervised and was found by police at a nearby hospital. The investigation revealed that staff did not witness Resident 2 leaving, and an LPN had only partially assisted them before directing them to another wing, failing to ensure continuous supervision. The Director of Nursing Services acknowledged that staff were expected to follow care plans, but the investigations into these incidents did not adequately address the failure to adhere to the care plans. The lack of adherence to individualized care plans and insufficient supervision directly contributed to the accidents involving both residents.
Breach of Resident Confidentiality by Staff
Penalty
Summary
The facility failed to ensure the confidentiality and privacy of a resident's personal and medical records. This deficiency occurred when a staff member, identified as Staff C, a Licensed Practical Nurse and Unit Manager, provided a copy of Resident 1's care plan to an unauthorized individual, referred to as CC2. CC2 was not listed as an authorized representative or contact for Resident 1, as confirmed by the facility's records, which showed that CC1 was the resident's Power of Attorney (POA) for Healthcare and Financial matters. Despite this, Staff C handed the care plan to CC2, believing it was permissible to share the information with them. The incident was brought to light during an interview with CC1, who stated that CC2, a visitor to the facility, was given Resident 1's care plan on or about August 14, 2024. CC1, who is the resident's POA, confirmed that CC2 was not authorized to receive any of Resident 1's private or confidential information. The facility's policy on Resident Rights- Privacy and Confidentiality, dated July 2024, mandates the respect of residents' rights to personal privacy and the security of their personal and medical records. This breach of confidentiality placed residents at risk for the loss of privacy and the right to have their preferences honored.
Inadequate Investigation of Resident Incidents
Penalty
Summary
The facility failed to conduct a thorough investigation for two residents, leading to deficiencies in care. Resident 1, who had a history of stroke and left-sided hemiparesis, experienced a fall with significant injury when a CNA, Staff D, assisted the resident without a second CNA as required by the care plan. The investigation incorrectly concluded that Staff D followed the care plan, failing to address the lack of a second staff member and the resident being left unsupported. The Director of Nursing Services (DNS) confirmed that Staff D was aware of the care plan but did not further investigate why the care plan was not followed. Resident 2, diagnosed with hemiplegia and muscle weakness, was found outside the facility by police, indicating an elopement incident. The facility's investigation, conducted by Staff B, did not assess the care plan for transfer or ambulation status, despite the care plan requiring supervision and one-person assistance for transfers and ambulation. The DNS stated that the expectation was for staff to follow care plans, but the investigation did not adequately address the failure to do so.
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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.
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Nursing homes near Bellingham
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Alderwood Park Health And Rehab Of Cascadia | 1.5 mi | — | 14 | 0 |
| Shuksan Rehabilitation And Health Care | 1.6 mi | — | 4 | 0 |
| North Cascades Health And Rehabilitation | 3.1 mi | — | 18 | 1 |
| Mt Baker Care Center | 4.1 mi | — | 1 | 0 |
| Highland Health And Rehabilitation Of Cascadia | 4.3 mi | — | 5 | 0 |
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