Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before 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 The Terraces At Skyline during CMS and state inspections, most recent first.
A resident's unexpected death was not promptly investigated or reported according to facility policy and state guidelines. The incident was not logged on the facility's incident reporting log until 19 days after the event, and staff confirmed that both the investigation and reporting were delayed.
The facility did not submit the required direct care staffing information to CMS for the fourth quarter of 2023 on time. Despite the facility's policy requiring timely electronic submission of staffing data, Staff J was unsure if the data was submitted, and Staff A confirmed it was not. This resulted in CMS having inaccurate staffing data, potentially affecting resident care.
The facility failed to ensure a homelike dining environment by allowing LPNs to administer medications during meals in the dining room, affecting six residents. Staff admitted that medications should be given in residents' rooms, and care plans did not include dining room administration. This oversight risked diminishing residents' quality of life.
The facility failed to provide the required RN coverage for six days, as revealed by interviews and record reviews. Despite having a policy mandating sufficient staffing and a minimum of 0.55 hours of RN care per resident per day, the facility's records showed a lack of eight-hour RN coverage on specific dates. The Staffing Coordinator could not explain the lapse, and the Administrator confirmed the requirement for RN coverage, acknowledging the facility's failure to meet this expectation.
The facility failed to properly label and store medications and supplies in two medication rooms, risking compromised effectiveness. On the Seventh Floor, a tuberculin vial was expired by three days. On the Eighth Floor, expired amoxicillin and catheters were found. Staff acknowledged these items should have been discarded.
The facility failed to discard expired food items and maintain a working thermometer in the Kitchen Walk-In Refrigerator, as observed during a survey. Expired Impossible Burger patties and raw pork chops were found, and two broken thermometers were identified, preventing accurate temperature monitoring. Staff acknowledged these issues, which contravened the facility's food safety policies.
A facility failed to ensure proper hand hygiene during meal tray distribution and medication administration. A CNA did not perform hand hygiene when entering and exiting resident rooms, including those requiring Enhanced Barrier Precautions. An LPN improperly handled medications by pouring them into gloved hands and taking medication bubble cards into resident rooms, contrary to facility policy. These actions increased the risk of infection for residents, visitors, and staff.
A resident was administered an antidepressant medication without obtaining informed consent beforehand, contrary to the facility's policy. The medication was prescribed and administered in March, but consent was not signed until late May. This was confirmed by the Resident Care Manager and the Corporate Director of Health Services, who both acknowledged the lapse in procedure.
The facility failed to assess and document self-medication administration for two residents. One resident self-administered enoxaparin injections without an assessment or physician order, while another resident self-administered multiple medications without proper documentation or orders. The facility did not follow its policy requiring assessments, orders, and care plan updates for self-medication.
A facility failed to provide a written transfer notice to a resident and their representative, as required by policy. The resident was transferred to a hospital, but the facility only notified the family by phone, contrary to the policy that mandates written notification. Staff interviews confirmed this practice, which did not align with the expectations of the Corporate Director of Health Services.
A resident was transferred to the hospital without being provided a bed hold notice, as required by the facility's policy. Staff interviews confirmed the oversight, and the Corporate Director of Health Services expected the notice to be given.
A resident admitted to hospice care experienced a delay in the completion of a Significant Change in Status Assessment (SCSA) MDS, which was completed four days late. This delay was acknowledged by the MDS Coordinator and the Corporate Director of Health Services, indicating a failure to adhere to the required 14-day timeline for assessments.
A facility failed to maintain consistent communication with hospice care for a resident, resulting in outdated hospice notes from December 2023 being the most recent available. Staff interviews revealed that hospice visit notes were not readily accessible, and there was a lack of coordination in care for the resident's left heel wound. This deficiency highlighted a failure in ensuring resident-centered care and treatment according to professional standards.
A resident's pressure ulcer was not properly assessed or documented, leading to a deficiency in care. The resident's left heel showed discoloration and later developed into a blister, which was treated as a pressure injury without proper staging. Staff interviews revealed a lack of documentation and clarity regarding the ulcer's stage, contrary to facility policy. This oversight placed the resident at risk for further deterioration.
Two residents with respiratory conditions were found with improperly labeled and stored oxygen supplies, including undated nasal cannulas and humidifier bottles. Staff interviews revealed a lack of physician orders and adherence to facility policy on oxygen administration, leading to a deficiency in respiratory care.
Failure to Timely Investigate and Report Unexpected Resident Death
Penalty
Summary
The facility failed to ensure that an incident involving the unexpected death of a resident was investigated and reported in a timely manner. According to the facility's policy and the Washington State Guidelines Purple Book, an immediate investigation and prompt logging of such incidents are required. However, review of records showed that the resident's unexpected death was not logged on the incident reporting log until 19 days after the event, and the investigation was not initiated promptly. The online incident report was completed six days after the resident's death, and the incident was not included in the April incident log, only appearing in the May log after a significant delay. Interviews with facility staff, including the Director of Health Services and the Interim DON, confirmed that the incident was neither investigated nor reported in accordance with required timelines. Staff acknowledged that the reporting and investigation were not completed in a timely manner, and the incident was logged late. These actions were not consistent with both facility policy and state guidelines, which require immediate response and documentation for unexpected deaths, especially those that are suspicious or not clearly related to abuse or neglect.
Failure to Submit Timely Staffing Data to CMS
Penalty
Summary
The facility failed to ensure timely submission of direct care staffing information to the Centers for Medicare and Medicaid Services (CMS) for the fourth quarter of the fiscal year 2023. This deficiency was identified during an interview and record review, which revealed that the Payroll Based Journal (PBJ) data, mandatory for reporting staffing information based on payroll data, was not submitted on time. The facility's policy, revised on July 1, 2024, mandates the electronic submission of complete and accurate staffing information, including agency and contract staff, in a uniform format as specified by CMS. However, Staff J, the Staffing/Central Supply Coordinator, was uncertain if the data for the fourth quarter of 2023 was submitted, and Staff A, the Administrator, confirmed that it was not submitted promptly. This failure resulted in CMS having inaccurate data related to nursing home staffing levels, potentially impacting resident care and services.
Medication Administration During Meals in Dining Room
Penalty
Summary
The facility failed to provide a homelike dining environment by allowing the administration of medications during meals in the dining room, which was observed during two of three dining observations involving six residents. Licensed nurses were seen administering oral medications to residents in the dining room during breakfast and lunch meals, contrary to the facility's policy that medications should be administered in residents' rooms. Staff F, an LPN, was observed giving medications to two residents during breakfast, and later admitted that medications should not have been administered in the dining room. Similarly, Staff E, another LPN, was observed administering medications to four residents during breakfast and lunch, and acknowledged that due to short-staffing, they sometimes administered medications in the dining room. Interviews with facility staff, including the Resident Care Manager and the Corporate Health Services Director, confirmed that the expectation was for medications to be administered in residents' rooms unless specifically included in the care plan. However, a review of the comprehensive care plans for the involved residents did not indicate that medication administration in the dining room was part of their care plans. This oversight placed the residents at risk for a diminished quality of life, as the dining room environment was not intended for medication administration.
Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to provide the required Registered Nurse (RN) coverage for six specific days, as identified in the report. This deficiency was discovered through interviews and record reviews, which revealed that the facility did not have RN coverage for eight hours on the dates of 10/07/2023, 10/08/2023, 10/15/2023, 10/21/2023, 10/22/2023, and 11/04/2023. The facility's policy, revised on 04/01/2024, mandates that staffing must be sufficient to ensure accurate direct care staffing information and that a minimum of 0.55 hours of direct nursing care per resident per day must be provided by RNs. Despite this policy, the Daily Nursing Staff Posting records confirmed the absence of the required RN coverage on the specified dates. During a joint record review and interview, the Staffing Coordinator acknowledged the lack of RN coverage on the identified dates but was unable to explain the reason for this lapse, despite stating that there was no staff shortage. The Administrator also confirmed the regulatory requirement for RN coverage and expressed the expectation that the facility should meet this requirement. The absence of RN coverage on these days placed residents at risk for inadequate assessments, delays in care services, unmet care needs, and a diminished quality of life, as per the findings of the report.
Improper Labeling and Storage of Medications and Supplies
Penalty
Summary
The facility failed to properly label and store medications and medical supplies in two medication rooms, which could compromise the effectiveness of these items. On the Seventh Floor, a multidose vial of tuberculin was found in the refrigerator with an open date that exceeded the 30-day usage period, indicating it was expired by three days. Staff C, the Resident Care Manager, acknowledged that the tuberculin should have been discarded as it was past its expiration date. On the Eighth Floor, a bottle of amoxicillin with an expiration date that had already passed was found in the medication room's refrigerator. Additionally, expired medical supplies, including two intermittent catheters and one Foley catheter, were discovered. Staff N, a Registered Nurse, confirmed that these items were expired and should have been discarded. Staff D, another Resident Care Manager, and Staff B, the Corporate Director of Health Services, both stated that the expired medications and supplies should have been removed from the medication rooms.
Expired Food and Broken Thermometers Found in Kitchen
Penalty
Summary
The facility failed to adhere to its food safety policies by not discarding expired food items and not maintaining a working thermometer in the Kitchen Walk-In Refrigerator. During an observation, a tray of Impossible Burger patties with a past use-by date and a tray of raw pork chops with an expired prep date were found in the refrigerator. Staff U, the Sous Chef, acknowledged the presence of these expired items and stated they would remove them. This indicates a lapse in the facility's policy that requires expired food to be removed immediately to prevent foodborne illness. Additionally, the facility did not ensure the proper monitoring of refrigerator temperatures as required by their policy. During the inspection, two thermometers in the Kitchen Walk-In Refrigerator were found to be broken, rendering them unable to provide accurate temperature readings. Staff U confirmed the malfunctioning state of the thermometers. The facility's policy mandates that temperatures in refrigeration units be checked daily and recorded to ensure food safety. The Administrator, Staff A, admitted that the expectation was to have a functioning thermometer inside the refrigerator and acknowledged the oversight in discarding expired foods promptly.
Infection Control Deficiencies in Hand Hygiene and Medication Administration
Penalty
Summary
The facility failed to ensure proper hand hygiene practices during meal tray distribution, as observed with Staff L, a Certified Nursing Assistant. Staff L was seen setting up meal trays for residents without performing hand hygiene before or after entering and exiting multiple resident rooms, including a room requiring Enhanced Barrier Precautions (EBP). Despite acknowledging the requirement to wash hands when entering and exiting EBP rooms, Staff L did not adhere to these protocols, as confirmed during interviews with the Resident Care Manager/Infection Preventionist and the Corporate Director of Health Services. Additionally, the facility did not follow infection control practices during medication administration for three residents. Staff E, an LPN, was observed preparing and administering medications by pouring them into their gloved hand before placing them in medication cups. This practice was repeated for Residents 6, 235, and 18, despite handling medication carts, bottles, and bubble cards with the same gloves. Staff E also took medication bubble cards into resident rooms, contrary to the facility's policy, which was confirmed by the Resident Care Manager and the Corporate Director of Health Services. The deficiencies in hand hygiene and medication administration practices placed residents, visitors, and staff at an increased risk of infection. The facility's policies on handwashing and medication administration were not followed, as evidenced by the actions of Staff L and Staff E. These lapses were identified through observations and interviews, highlighting a need for adherence to established infection control protocols to prevent contamination and infection.
Failure to Obtain Informed Consent for Antidepressant Medication
Penalty
Summary
The facility failed to ensure informed consent was obtained for an antidepressant medication before administration to a resident. The facility's policy on psychotropic drug use requires that residents or their responsible parties make an informed choice regarding the use of such medications, with potential risks and benefits explained beforehand. However, a review of the resident's records revealed that the antidepressant medication was prescribed on 03/19/2024 and administered starting 03/20/2024, but the consent was not signed until 05/28/2024. This oversight was confirmed during a joint record review and interview with the Resident Care Manager, who acknowledged that consent should have been obtained prior to the medication's administration. The Corporate Director of Health Services also stated that the expectation was for consent to be completed before the resident began taking the medication.
Failure to Assess and Document Self-Medication Administration
Penalty
Summary
The facility failed to ensure that residents were properly evaluated and assessed for self-administration of medications, and did not obtain necessary physician orders for two residents. Resident 235, who had been self-administering enoxaparin injections since before their admission, continued to do so without an assessment, physician order, or care plan in place. Despite the resident's preference and history of self-administration, the facility staff did not conduct the required evaluations or update the care plan to reflect this practice. Similarly, Resident 20 was self-administering multiple medications, including Fluticasone Nasal Spray and Ponaris Nasal Solution, without the necessary physician orders or inclusion in their comprehensive care plan. The facility's records did not show a self-administration order for these medications, and the resident's care plan lacked documentation for self-medication administration. Observations revealed that medications were left at the resident's bedside for unsupervised use, further indicating a lack of proper oversight and documentation. The facility's policy required an interdisciplinary team assessment, physician orders, and care plan updates for residents who self-administer medications. However, these procedures were not followed for Residents 235 and 20, leading to a deficiency in ensuring safe and accurate medication administration. The lack of assessments and orders placed the residents at risk for potential medication errors and adverse effects.
Failure to Provide Written Transfer Notice
Penalty
Summary
The facility failed to provide a written transfer or discharge notice to a resident and their representative, as required by their policy and regulatory standards. This deficiency was identified during a review of the case of a resident who was transferred to a hospital for further evaluation. The facility's policy, revised in April 2024, mandates that residents be notified in writing of the reasons for a transfer in a language and manner they can understand, and that this notice be documented in the resident's record by the facility and the physician. However, the review of the clinical health record, both electronic and paper, revealed no documentation of such a written notice being provided to the resident or their representative. Interviews with facility staff, including a Licensed Practical Nurse and the Resident Care Manager, confirmed that the standard practice was to notify family or representatives of hospital transfers by phone, rather than in writing. This practice was contrary to the facility's policy and the expectations stated by the Corporate Director of Health Services, who emphasized the requirement for written notification. The lack of written notice placed the resident and their representative at risk of not having the opportunity to make informed decisions regarding the transfer or discharge.
Failure to Provide Bed Hold Notice During Hospital Transfer
Penalty
Summary
The facility failed to provide a bed hold notice to a resident or their representative during a transfer to the hospital, as required by their policy. The policy, revised in January 2024, mandates that written information regarding bed hold policies be given prior to a resident's transfer to the hospital or when they go on therapeutic leave. However, a review of the clinical health records for the resident, who was transferred to the hospital on May 28, 2024, showed no documentation of a bed hold notice being offered. Interviews with facility staff, including a Licensed Practical Nurse and the Resident Care Manager, confirmed that the bed hold notice was not provided to the resident or their representative. Both staff members acknowledged that the notice should have been given. Additionally, the Corporate Director of Health Services stated that it was their expectation for the facility to provide the bed hold notice, indicating a lapse in following the established protocol.
Delayed Completion of SCSA MDS for Resident in Hospice Care
Penalty
Summary
The facility failed to complete a Significant Change in Status Assessment (SCSA) Minimum Data Set (MDS) in a timely manner for a resident who experienced a significant change in condition. According to the Long-Term Care Resident Assessment Instrument (RAI) 3.0 User's Manual, an SCSA is required to be completed within 14 days of a significant change in a resident's status. In this case, the resident was admitted to hospice care, which is considered a significant change requiring an SCSA. However, the assessment was completed four days late, placing the resident at risk for unmet care needs and a diminished quality of life. The report details that the resident was admitted to hospice care on September 22, 2023, and the SCSA MDS with an Assessment Reference Date (ARD) of September 27, 2023, was not completed until October 10, 2024. This delay was confirmed during an interview with the MDS Coordinator, who acknowledged that the assessment was completed late according to the RAI manual. The Corporate Director of Health Services also stated that they expected the SCSA MDS to be completed in a timely manner, indicating a lapse in adherence to the required timeline for assessments.
Failure in Communication with Hospice Services
Penalty
Summary
The facility failed to ensure resident-centered care and treatment were provided in accordance with professional standards of practice by not maintaining consistent communication and collaboration with hospice care for a resident receiving hospice services. The deficiency was identified for a resident who was admitted to hospice care in September 2023, but the most recent hospice notes available in the facility's records were from December 2023. This lack of updated documentation indicated a failure in communication between the facility and hospice care, which is essential for coordinating care and ensuring the resident's needs are met. During interviews, staff members acknowledged the absence of recent hospice notes in the resident's records. A Licensed Practical Nurse was unable to find any hospice visit notes related to the resident's left heel wound in the Electronic Health Record (EHR) or paper chart. The Resident Care Manager admitted that they did not expect hospice notes to be readily available but could request them if needed. The Corporate Director of Health Services expressed that there should be both verbal and written communication to coordinate care and that hospice notes should be readily available in the facility after a hospice visit. The lack of recent hospice documentation placed the resident at risk of not receiving necessary comfort care services and unmet care needs.
Failure to Properly Assess and Document Pressure Ulcer
Penalty
Summary
The facility failed to properly assess and document a pressure ulcer for a resident, identified as Resident 9, which led to a deficiency in care. Initially, the resident's left heel showed discoloration, but it was not identified or documented as a pressure ulcer. Despite the presence of a blister that opened and was treated as a pressure injury, the facility did not stage the wound as required. Interviews with staff revealed a lack of clarity and documentation regarding the staging of the pressure ulcer, which was expected to be done once the blister opened. Further observations and interviews indicated that the pressure ulcer was unstageable with parts classified as Stage 2, yet this was not documented in the facility's records. The facility's policy required thorough assessment and documentation of pressure ulcers, including staging, which was not adhered to in this case. The lack of proper documentation and assessment placed the resident at risk for deterioration of their pressure ulcer and a diminished quality of life.
Improper Oxygen Supply Management for Residents
Penalty
Summary
The facility failed to maintain, label, date, and properly store oxygen tubing and supplies for two residents, leading to a deficiency in respiratory care. Resident 23, who was admitted with pulmonary fibrosis, was observed using an oxygen concentrator and a portable oxygen device without proper labeling or storage of the nasal cannula and humidifier bottle. The nasal cannula was found uncovered on the concentrator and the tubing from the portable device was on the floor, both undated. Staff interviews revealed that there were no physician orders for oxygen or protocols for changing the tubing and humidifier bottle, despite documentation indicating the need for oxygen since May 2024. Resident 20, diagnosed with chronic respiratory failure, was also found with improperly labeled and stored oxygen equipment. The nasal cannula connected to the oxygen concentrator and the portable oxygen tank were not labeled or dated. Interviews with staff indicated that Resident 20 managed their own oxygen and requested tubing changes as needed, but there were no physician orders for oxygen therapy prior to August 2024. The facility's policy required oxygen supplies to be dated and stored correctly, which was not adhered to in these cases. The deficiency was identified through observations, interviews, and record reviews, highlighting the facility's failure to follow its own policy on oxygen administration. Staff acknowledged the lack of proper documentation and storage practices, which placed the residents at risk for unmet care needs and potential respiratory complications. The absence of physician orders and proper labeling and storage of oxygen supplies were central to the deficiency identified by the surveyors.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 1,101 citations issued within 25 miles in the last 12 months — including the 3 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
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Seattle
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Mirabella | 0.8 mi | — | 2 | 0 |
| Seattle Medical Post Acute Care | 0.9 mi | — | 44 | 0 |
| Transitional Care Of Seattle | 1.6 mi | — | 49 | 0 |
| Bailey-boushay House | 1.8 mi | — | 0 | 0 |
| Washington Care Center | 2.7 mi | — | 30 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for The Terraces At Skyline.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.