Skilled nursing facility · CMS certification number 505493
PARK SHORE
SEATTLE, Washington · Medicare and Medicaid
Certified beds, as filed in Care Compare: 28
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 October 2023 to 30 September 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 12 March 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,615,959 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $948,771 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,667,188 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $23,274,662 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$19,607,474 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $25,703,351 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $6,095,877 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $6,095,877 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 10,248 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,758 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 790 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 3,756 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 6,304 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 54 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 1 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 63 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 118 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 790 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 53.42 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1405126, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 30 September 2023
Cost report for 1 October 2022 to 30 September 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 March 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,899,189 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $910,515 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,988,674 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $22,309,147 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$19,320,473 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $19,769,043 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $448,570 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $448,570 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 5,863 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 100 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 601.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 58.63 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1375291, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 30 September 2022
Cost report for 1 October 2021 to 30 September 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 5 May 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,899,509 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $708,779 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,190,730 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,297,086 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$17,106,356 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $13,570,404 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,535,952 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,535,952 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 6,773 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 20.08 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,500 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 112.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1346880, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 30 September 2021
Cost report for 1 October 2020 to 30 September 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 8 June 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,954,790 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $958,900 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,995,890 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,386,167 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$17,390,277 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,970,607 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,419,670 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,419,670 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 6,808 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 61 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.15 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,538 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 111.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1318833, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 30 September 2020
Cost report for 1 October 2019 to 30 September 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 19 May 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,719,892 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,238,977 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,480,915 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,789,380 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$16,308,465 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $14,504,898 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,803,567 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,803,567 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,521 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 128 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 946.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 58.76 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1284161, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 30 September 2019
Cost report for 1 October 2018 to 30 September 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 31 March 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,956,310 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,284,868 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,671,442 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,909,285 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$13,237,843 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $13,673,728 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $435,885 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$284,086 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,706 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 132 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 784.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 65.95 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1253481, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 30 September 2018
Cost report for 1 October 2017 to 30 September 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 March 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,373,867 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $763,332 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,610,535 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,441,984 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,831,449 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,270,324 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $438,875 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $438,875 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,638 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 133 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 57.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1222186, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 30 September 2017
Cost report for 1 October 2016 to 30 September 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 2 May 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,909,668 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,110,933 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,798,735 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,654,697 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,855,962 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,869,732 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,013,770 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,013,770 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,706 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 93 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 66.71 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 93.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1187920, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 30 September 2016
Cost report for 1 October 2015 to 30 September 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 April 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,250,869 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $609,870 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,640,999 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $58,826,628 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$48,185,629 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,467,554 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$38,718,075 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$38,718,075 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,738 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 77 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 989 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 113.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1156560, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 30 September 2015
Cost report for 1 October 2014 to 30 September 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 April 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,018,041 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $596,637 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,421,404 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,435,033 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,013,629 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,981,776 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $968,147 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $968,147 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,785 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.36 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 117.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1121814, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 30 September 2014
Cost report for 1 October 2013 to 30 September 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 18 March 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,744,684 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $537,685 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,206,999 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,678,848 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,471,849 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,176,698 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,704,849 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,704,849 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,125 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 57 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 160.09 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1087327, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 30 September 2013
Cost report for 1 October 2012 to 30 September 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 9 May 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,857,517 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $546,723 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,310,794 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,720,872 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,410,078 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,923,109 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,513,031 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,513,031 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,955 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 91 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.16 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,311 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 98.41 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1059654, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 30 September 2012
Cost report for 1 October 2011 to 30 September 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 23 May 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,222,136 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $645,417 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,576,719 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,024,259 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,447,540 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,541,291 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,093,751 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,093,751 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,659 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 103 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,098 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 84.07 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1030137, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 30 September 2011
Cost report for 1 October 2010 to 30 September 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 19 September 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,795,496 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,608,555 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$813,059 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,277,873 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $2,464,814 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 9,420 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 103 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.58 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 623.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 91.46 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 435336, read from the public cost report file SNFFY2011.zip.
Fiscal year 2010, ended 30 September 2010
Cost report for 1 October 2009 to 30 September 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 April 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,171,252 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,226,640 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,055,388 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,635,128 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $1,579,740 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 28 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 9,124 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 150 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 20.32 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 390.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 60.83 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 398147, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 30 September 2009
Cost report for 1 October 2008 to 30 September 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 29 April 2010.
None of these figures is carried on this report.
CMS report record 368534, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 30 September 2008
Cost report for 1 October 2007 to 30 September 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 28 May 2009.
None of these figures is carried on this report.
CMS report record 340743, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 30 September 2007
Cost report for 1 October 2006 to 30 September 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 April 2008.
None of these figures is carried on this report.
CMS report record 307985, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 30 September 2006
Cost report for 1 October 2005 to 30 September 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 19 February 2008.
None of these figures is carried on this report.
CMS report record 302470, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 30 September 2005
Cost report for 1 October 2004 to 30 September 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 29 December 2006.
None of these figures is carried on this report.
CMS report record 269833, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 30 September 2004
Cost report for 1 October 2003 to 30 September 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 18 August 2005.
None of these figures is carried on this report.
CMS report record 231038, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 30 September 2003
Cost report for 1 October 2002 to 30 September 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 April 2004.
None of these figures is carried on this report.
CMS report record 174561, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 August 2002
Cost report for 1 September 2001 to 31 August 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 7 April 2003.
None of these figures is carried on this report.
CMS report record 142143, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended 31 August 2001
Cost report for 1 September 2000 to 31 August 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 12 February 2003.
None of these figures is carried on this report.
CMS report record 117757, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended 31 August 2000
Cost report for 1 September 1999 to 31 August 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 16 July 2004.
None of these figures is carried on this report.
CMS report record 187595, read from the public cost report file SNFFY1999.zip.
Fiscal year 1999, ended 31 August 1999
Cost report for 1 September 1998 to 31 August 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 29 June 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,478,310 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,501,294 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$3,022,984 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,897,249 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $1,874,265 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 30 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,327 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 115 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 21.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 385.14 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 72.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 67961, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended 31 August 1998
Cost report for 1 September 1997 to 31 August 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 3 July 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,627,070 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,514,996 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$3,887,926 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,774,417 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $886,491 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 30 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,405 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.03 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 587 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 105.06 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 67959, read from the public cost report file SNFFY1997.zip.
Fiscal year 1997, ended 31 August 1997
Cost report for 1 September 1996 to 31 August 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 5 August 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,563,878 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,467,048 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$3,903,170 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,170,057 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $266,887 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 30 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,910 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 86 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.89 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 546 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 103.6 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 67957, read from the public cost report file SNFFY1996.zip.
Fiscal year 1996, ended 31 August 1996
Cost report for 1 September 1995 to 31 August 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 25 June 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,237,856 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,774,446 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$3,536,590 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,717,094 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $180,504 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 30 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,792 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 66 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.74 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,419 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 133.21 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 67955, read from the public cost report file SNFFY1995.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated 1 August 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/1966 |
| MCNAMARA, KEVIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/03/2013 |
| SCHWARTZ, MICHAEL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/15/2016 |
| MELHORN, JAMES | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2008 |
| HIRCHE, TORSTEN | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 03/31/2014 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST (enrollment ID O20100802000388).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/1966 | Private equity company: No Real estate investment trust: No Holding company: No |
| KEVIN MCNAMARA | Individual | CORPORATE DIRECTOR | 0 | 9/3/2013 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MICHAEL D SCHWARTZ | Individual | CORPORATE DIRECTOR | 0 | 9/15/2016 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JAMES I MELHORN | Individual | OPERATIONAL/MANAGERIAL CONTROL | 0 | 6/1/2008 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DOUGLAS S DIEKEMA | Individual | OTHER | 0 | 6/1/2009 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| GREGORY S ROBINSON | Individual | OTHER | 0 | 6/1/2008 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JAMES R RAND | Individual | OTHER | 0 | 6/1/2012 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOHN P IWANSKI | Individual | OTHER | 0 | 6/1/2013 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| KARIN L MILLER | Individual | OTHER | 0 | 6/1/2016 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| PAULA FITZGERALD BOOS | Individual | OTHER | 0 | 6/1/2012 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SCOTT A LUMSDEN | Individual | OTHER | 0 | 6/1/2015 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| VINCENT M DRIANO | Individual | OTHER | 0 | 6/1/2011 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TORSTEN HIRCHE | Individual | W-2 MANAGING EMPLOYEE | 0 | 3/31/2014 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 August 2023: GERALD R SCHOEGGL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
Recent changes on this record
- 12 March 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 20 March 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 1 August 2023: GERALD R SCHOEGGL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- 5 May 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 8 June 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 19 May 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 31 March 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 29 March 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 2 May 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 28 April 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 20 April 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 18 March 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 9 May 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 19 September 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
- 23 May 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 28 April 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- 29 April 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 28 May 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 30 April 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 19 February 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 29 December 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 18 August 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 16 July 2004: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY1999.zip
- 27 April 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 7 April 2003: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- 12 February 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
- 29 June 2001: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1998.zip
- 3 July 2000: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1997.zip
- 5 August 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1996.zip
- 25 June 1998: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1995.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 8 December 2025 | 8 December 2025 | 14 | 22 |
| 2 | 16 October 2024 | 16 October 2024 | 11 | 4 |
| 3 | 16 June 2023 | 16 June 2023 | 25 | 36 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
50 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 8 December 2025 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0656 | 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. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0732 | Nursing and Physician Services Deficiencies | Post nurse staffing information every day. | C | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | 13 January 2026 |
| 8 December 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 13 January 2026 |
| 12 September 2025 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | Yes | Deficient, Provider has date of correction | 27 October 2025 |
| 12 September 2025 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Yes | Deficient, Provider has date of correction | 27 October 2025 |
| 16 October 2024 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0645 | Resident Assessment and Care Planning Deficiencies | PASARR screening for Mental disorders or Intellectual Disabilities | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0656 | 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. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0657 | 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. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 30 November 2024 |
| 16 October 2024 | Health | F 0925 | Environmental Deficiencies | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F | No | Deficient, Provider has date of correction | 30 November 2024 |
| 9 October 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | Yes | Deficient, Provider has date of correction | 25 November 2023 |
| 16 June 2023 | Health | F 0554 | Resident Rights Deficiencies | Allow residents to self-administer drugs if determined clinically appropriate. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0582 | Resident Rights Deficiencies | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0637 | Resident Assessment and Care Planning Deficiencies | Assess the resident when there is a significant change in condition | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0640 | Resident Assessment and Care Planning Deficiencies | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0645 | Resident Assessment and Care Planning Deficiencies | PASARR screening for Mental disorders or Intellectual Disabilities | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0655 | Resident Assessment and Care Planning Deficiencies | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0656 | 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. | E | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0657 | 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. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0687 | Quality of Life and Care Deficiencies | Provide appropriate foot care. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0801 | Nutrition and Dietary Deficiencies | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | F | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0803 | Nutrition and Dietary Deficiencies | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | C | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0838 | Administration Deficiencies | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | F | No | Deficient, Provider has date of correction | 24 July 2023 |
| 16 June 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 24 July 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST |
| Date First Approved to Provide Medicare and Medicaid Services | 1995-08-10 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | Y |
| Urban | Y |
| County/Parish | King |
| Telephone Number | 2063290770 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 28 |
| Average Number of Residents per Day | 17.2 |
| Overall Rating | 4 |
| Health Inspection Rating | 3 |
| QM Rating | 5 |
| Long-Stay QM Rating | 4 |
| Short-Stay QM Rating | 5 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on PARK SHORE: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 12 March 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for PARK SHORE
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Washington at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 505493.