NH LICENSED CN LICENSE LICENSED TYPE A SWING APPVD …Hospital Long Term Care Unit. Regency Canyon...
Transcript of NH LICENSED CN LICENSE LICENSED TYPE A SWING APPVD …Hospital Long Term Care Unit. Regency Canyon...
Washington State Certificate of Need
Nursing Home Bed Supply Log
Avalon Care Center-Othello, LLC 1359 39 0 0 0 0 0 0 0 39
7/1/95 banked 8 beds; 7/1/97 bank 2 beds;
7/1/98 name chg-formerly Othello Conv Ctr.
10/1/98 banked 3 beds. 7/1/99 extension
denied, lost 8 beds.10/1/02 extend 3 banked
beds, 2 beds forfeited from 7/1/97. 12/17/03
CHOW aka Beverly Healthcare, 3 banked
beds forfeited. CHOW licensee banked 10
beds 3/09 BB09-14 - Voluntary relinq of 10
beds 9/29/10
East Adams Care Center, LLC 1509 0 0 0 0 0 0 50 0 50
11/12/98 banked 11 beds. 11/1/02-Extended
11 banked beds. 11/23/03-converted 11
beds. 06/14/04 rebanked 11 beds-38 months
remaining; no extension. Unbanked 11 beds
beginning 12-19-05 Part of March 2007
Settlement. 05/01/15 CHOW formerly Life
Care Center of Ritzville. 02/14/17 FFC
banked 50 beds 02/14/25
East Adams Rural Hospital N/A 0 0 12 0 0 0 0 0 002/02/17 approved to increase swing beds
from 5 to 12. [DOR 17-04]
Othello Community Hospital N/A 0 0 5 0 0 0 0 0 0 Swing Beds 10/04/02
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR ADAMS 39 0 17 0 0 0 50 0 89
Prestige Care & Rehabilitation-Clarkston 1455 90 0 0 0 0 0 0 0 90
Formerly Clarkston Care Center. CHOW
10/01/12 formerly Eagle Rehab at Clarkston
Tri-State Memorial Hospital N/A 0 0 5 0 0 0 0 0 0 8/13/04 approved for 5 swing beds
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR ASOTIN 90 0 5 0 0 0 0 0 90
Life Care Center of Kennewick 1381 136 0 0 0 0 0 0 0 136
11/1/98 bank 12 beds.11/1/02-extended 12
BB. All 12 beds converted 09/25/05. Part of
March 2007 Settlement. Converted 12 beds
May 2007(07-05 & 07-36) effective 1-30-08
Life Care Center of Richland 1383 104 0 0 0 0 0 0 0 104
9/1/95 bank 9 beds. 9/1/99 extend to 9/1/03.
10/01/01 bank 17 beds.6/1/03- Convert
11beds. 11/23/03 all 15 BB converted. Part of
March 2007 Settlement - BB Mod 7/08 - 2
bed extension 09-04 - 09-08 Ext of last 2 BB -
Conv of 2 beds 3/10. Conv 13 beds 6/2010
Prosser Memorial Hospital Long Term
Care Unit (CN #1743 issued 08/31/18) 0 0 0 36 0 0 0 0 36
CN #947 issued 7/88-complete - FFC
10/2010 of 36 bed unit. FFC beds expire on
9/2/18. 08/31/18 CN #1743 issued to Prosser
Memorial Hospital for a 36-bed NH in
Richland to be named: Prosser Memorial
Hospital Long Term Care Unit.
Regency Canyon Lakes Rehabilitation
and Nursing Center 1537 53 0 0 0 0 0 0 0 53
8/1/94 change of operator; 1/4/96 RA#001;
4/10/98 RA complete, name chg-formerly
Vistavue Care Center (closed 4/25/98).
06/01/16 CHOW formerly Canyon Lakes
Restorative and Rehabilitation Center.
09/01/17 Name change only-formerly
Regency Kennewick Rehabiltation and
Nursing Center
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
printed 1/7/2020...12:11 PM 1 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Richland Rehabilitation Center 1452 71 0 0 0 0 0 0 0 71
6/30/95 bank 14 beds; (see Order); convert
date extend to 6/30/01 per Order - addtl 2 yr
extend to 6/30/03; 3/23/00 convert all 14 beds
back to skilled nursing use. 9/27/00 RA #032
issued for replacement of Walnut Grove
Nursing Home. 12/29/04 Replace facility- was
known as Walnut Grove Nursing Home.
CHOW 10/01/12 no name change.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR BENTON 364 0 0 36 0 0 0 0 400
Cascade Medical Center CLOSED 0 0 5 0 0 0 0 0 03/96 name change, formerly Cascade
General Hospital
Cashmere Care Center 1588 65 0 0 0 0 0 0 0 65
Banked 12 beds 6/07 - Jan 2010 voluntary
relinquishment of 24 beds (including 12
banked & 12 licensed). 08/28/13 approved to
bank 21 beds under AU. 9/1/13 DSHS
identified AU bb approval. 08/17/17 Request
to convert 21 AU banked beds not timely.
Loss of 21 AU beds. Year 2017 CHOW &
name change. formerly Cashmere
Convalescent Center. 02/15/19 CHOW & no
name change.
Central Washington Hospital N/A 0 0 0 0 0 0 22 0 22
6/14/93 CN #917RA - TCU FFC closure
(BB10-02) of 30 beds effective 7-31-09; CN
#1454 issued on 9/13/11 approving a 22 bed
TCU. 11/15/18 approval for 22 FFC banked
beds 10/31/26
Colonial Vista Post Acute & Rehabilitation
Center 1541 100 0 0 0 0 0 0 0 100
1/1/94 name change; 11/8/96 RA #012;
5/8/98 name chg-formerly Colonial Vista
Village Care & Rehab Ctr; 8/1/00 CHOW.
01/06/17 CHOW & name change-formerly
Colonial Vista Care Center
Lake Chelan Community Hospital CLOSED 0 0 5 0 0 0 0 0 0
Regency Wenatchee Rehabilitation and
Nursing Center 1539 55 0 0 0 0 0 0 0 55
7/1/95 bank 6 beds; 5/1/96 chg owner; lost 6
beds per CHOW; 10/1/98 bank 14 beds.
4/01/01 banked 5 beds.14 beds banked
10/01/98 forfeited.03/04/05-Extended 3 beds
banked on 04/01/01 to 04/01/09, loss of 2
beds. 3 Beds lost with expiration of BB on
4/1/09. 09/03/13 Replacment Authorization
issued to relocate from Chelan to Wenatchee.
08/01/16 CHOW & name change-formerly
Regency Manor.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR CHELAN/DOUGLAS 220 0 10 0 0 0 22 0 242
Avamere Olympic Rehabilitation of
Sequim 1374 125 0 0 0 0 0 0 0 125
7/6/98 CN #1180 issued to consolidate
Olympic Health Care (60 beds) and Sherwood
Manor (65 beds) for a 125 bed facility. DSHS
licensed. 02/01/05 CHOW type: CHOPR was
Olympic Health Care, new licensee is Sequim
Rehab, LLC. Formerly Olympic Care and
Rehabilitation Center
printed 1/7/2020...12:11 PM 2 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Crestwood Health and Rehabilitation
Center 1562 101 0 0 0 0 0 0 0 101
11/1/95 change owner; 8/1/99 banked 6
beds.7/14/01-11 beds banked. 10/13/02,
convert 3. Extend BB of 8/1/99 to 8/3/07.
11/23/04 3 beds converted, 11 remain
banked. Extend 5 beds banked on 07/14/05-
no further extensions. Conv 6 beds 07-42 &
Conv 5 beds 07-45 - Reduced at licensee
request - See DSHS letter - RA 63 tranfered
11 beds to Sequim/Port Angeles. 3/18/13
name change: formerly Crestwood
Convalescent Center. 7/1/15 CHOW.
12/01/17 CHOW.
Forks Community Hospital N/A 12 0 25 0 0 0 0 0 12
3/18/02-Voluntary forfeiture of 16 LTC beds.
20 LTC beds remaining. 05/26/16 relinquish 8
LTC beds, for a total of 12.
Sequim Health and Rehabilitation Center 1563 100 0 0 0 0 0 0 0 100
7/1/95 bank 14 beds; Change general
partner, PFP Alpha Corp to become general
partner; 4/1/98 volunt. forfeit 14 banked beds-
CHOW-Fir Lane Conv Ctr Inc operator.
04/15/98 banked 13 beds.5/1/02 extend 13
beds, date corrected by DSHS, 8 yr expiration
05/01/06.7/1/01-5BB. 02/1/04 CHOW 18
beds converted. 02/14/04 18 beds banked,
Expiration date extended 2 days
only.11/24/04 Convert 3 BB, 15 beds remain
banked.03/01/05 2 beds converted. 08/22/25
all 13 beds converted. Delicensed and
decertified 11 beds with DSHS 9-22-05 -
added 11 back from other facility in RA63.
7/1/15 CHOW.Name change: formerly
Sequim Nursing and Rehabilitation Center.
12/01/17 CHOW.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR CLALLAM 338 0 25 0 0 0 0 0 338
Avamere Rehabilitation of Cascade Park 1508 88 0 0 0 0 0 0 0 88
4/95 new facility. 2/01/99 CHOW. 04/01/15
CHOW formerly Cascade Park Care Center
Brookfield Health and Rehabiltation of
Cascadia 1552 83 0 0 0 0 0 0 0 83
7/1/97 chg of oper-Eagle HC.6/30/01-8
BB.06/30/05 extended 8 beds-expire
06/30/09=no extension. Converted all 8
effective 7-2-07 - CHOW 8-1-07 formerly
Parkway North. 12/12/16 name change only-
formerly Victory Health & Rehab of Battle
Ground. 09/01/17 CHOW formerly Victory
Rehabilitation and Healthcare Center
Discovery Nursing & Rehab of Vancouver 1353 89 0 0 0 0 0 0 0 89
1/1/95 formerly Whispering Pines Care
Center; 4/7/98 name chg-formerly Covington
Med & Rehab Ctr. 6/1/99 name chg-formerly
Sunrise Care & Rehab for
Vancouver.10/01/03-CHOW from Sunbridge
Care & Rehab for Vancouver. 04/01/04-Name
Change formerly Hazel Dell Nursing & Rehab
Center.
Fort Vancouver Post Acute 1527 92 0 0 0 0 0 0 0 9211/01/15 CHOW-formerly Fort Vancouver
Convalescent Center
printed 1/7/2020...12:11 PM 3 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
ManorCare Health Services - Salmon
Creek 1594 120 0 0 0 0 0 0 0 120
4/4/08-CN #1366 issued for estab of 120 bed
NH in Clark County. While this approval was
under adjudicative appeal, HLJ Kuntz
approved a stay of the commencement date.
Once the appeal was withdrawn, the stay was
lifted, resulting in the issuance of CN #1366E
with an expiration date of 11/13/10. 08/05/18
CHOW. 01/01/20 CHOW
Prestige Care & Rehabilitation-Camas 1450 83 0 0 0 0 0 0 0 83
1/1/95 change of ownership; 6/30/95 bank 41
beds; convert date extend to 6/30/01 per
Order - addtl 2 yr extend to 6/30/03.06/30/01
bank 7 beds.41 beds banked 6/30/95
forfeited. 06/30/05-7 beds extended until
06/30/09; no extension. Loss of 7 BB with
exp of BB timeline. CHOW 10/01/12 formerly
Highland Terrace Nursing Center.
The Oaks at Timberline 1569 98 0 0 0 0 0 0 0 98
name chg-formerly Hillhaven Conv Ctr; 7/1/98
oper chg. Name chg formerly Vencor of
Vancouver. Formerly Vancouver Health and
Rehabilitation Center. 12/20/17 CHOW.
Fomerly Kindred Transitional Care and
Rehabilitation-Vancouver.
Vancouver Specialty and Rehabilitative
Care 1572 104 0 0 0 0 0 0 0 104
6/30/95 bank 11 beds DSHS licensed on
9/1/95; 1/96 formerly Emerald Terrace
Nursing; 7/1/96 bank 17 beds; 7/1/97 bank 13
beds. Extended 11 beds banked on 9/1/95 to
7/1/2003 (these beds cannot be extended
another 4 years); 7/1/00 forfeit 17 beds (letter
sent 6/15/00). Reminder mailed 1/18/01 for 13
beds banked 7/1/97. 3/29/01 extended 13
beds banked on 7/1/97 to 7/1/05 (these beds
cannot be extended another 4 years).
Forfeited 3 beds due to expire on 9/1/03.
Converted 8 beds due to expire on 9/1/03. 13
beds remain banked. 11/01/03 all beds
converted. 5/09 voluntary relinquishment of
17 beds - Voluntary req. to delicense 11 beds
rc'vd 11/30/09. 7/1/15 CHOW. 04/18/18
CHOW-formerly Pacific Specialty and
Rehabilitative Care.-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR CLARK/SKAMANIA 757 0 0 0 0 0 0 0 757
Booker Rest Home Annex N/A 23 0 0 0 0 11 0 0 34
Reduced from 46 to 34 as part of the
conversion of license to Dayton Hospital.
11/29/17 AU bed banking for 11 beds. 11/29/21
Dayton General Hospital N/A 0 0 5 0 0 0 0 0 0
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR COLUMBIA 23 0 5 0 0 11 0 0 34
Americana Health and Rehabilitation
Center 1223 74 0 0 0 0 0 0 0 74
10/94 change of owner;5/1/97 chg of
operator; name chg-formerly Americana Conv
Home; 5/1/98 bank 8 beds; 6/10/98 bank 2
beds. 5/1/02 extend 8 banked beds, 6/1/02
extend 2 banked beds. Missed 90 deadline
and relinquished 8 beds effective May 1, 2006
- Unbanked 2 remaining beds 5/21/06
printed 1/7/2020...12:11 PM 4 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Beacon Hill Rehabilitation 1466 67 0 0 0 0 0 0 0 67
7/1/98 oper chg. 3/1/02-5 beds banked. -
extended to 2010 - BB08-27 banked 2
additional beds for remaining 29 months.
Voluntary relinquishment of 5 beds and
denied conversion of 2 BB in 8/2010.
Formerly Northwest Continuum Care Center.
7/1/14 CHOW formerly Kindred Transitional
Care & Rehab-Beacon Hill.
Frontier Rehabilitation and Extended Care
Facility 1225 140 0 0 0 0 0 0 0 140
10/94 change of owner; 5/1/97 chg of
operator; name chg-formerly Frontier
Extended Care Fac. 09/01/03-6 beds banked.
Loss of 6 beds 4yr BB expiration
Park Royal Health and Rehabilitation
Center CLOSED 0 0 0 0 0 0 50 0 50
4/29/99 CHOW. CHOW 2/1/03-was Park
Royal Medical.09/01/03-17beds banked.
Unbanked 5 in amended app on 10-12-06 -
lost 12 beds in 4 yr expiration of BB. 50 beds
banked effective 08/16/19 08/16/27
Woodland Convalescent Center 749 62 0 0 0 0 0 0 0 62
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR COWLITZ 343 0 0 0 0 0 50 0 393
Ferry County Memorial Hospital-TCU CLOSED 0 0 4 0 0 0 0 0 0
Voluntary closed 6-30-04 - Cited 18 beds ((14
LTC / 4 Swing); Did not bank any of the beds
under FFC
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR FERRY 0 0 4 0 0 0 0 0 0
Avalon Health & Rehabilitation Center-
Pasco 1362 108 0 0 0 0 0 0 0 108
7/1/95 name change; formerly Hillcrest
Convalescent Center. 12/17/03 CHOW aka
Beverly Healthcare Pasco. Banked 17 beds
3/09 BB09-15. 12/18/12 4 year extension on
17 AU beds. 03/01/17 17 AU banked beds
expired
Our Lady of Lourdes Hosp-LTC U CLOSED 0 0 5 0 0 0 0 0 0
9/15/04 approval for 5 swing beds. 04/01/05
21-bed TCU (SNF) closed; FFC BED
BANKING NOT REQUESTED. ALL 21
BEDS RELINQUISHED.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR FRANKLIN 108 0 5 0 0 0 0 0 108
Garfield County Memorial Hospital CLOSED 16 0 5 0 0 0 20 0 36
Per 9/12/01 ltr from Byron Plan-Hospital
relinquished 4 NH beds. Hospital has 9 AC
and 36 NH beds. 10/16/02 of the 9 AC beds,
5 are swing. 01/18/112 FFC of 20-bed TCU
unit 01/18/20
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR GARFIELD 16 0 5 0 0 0 20 0 36
Columbia Basin Hospital N/A 12 0 6 0 0 0 0 0 12
CN #801 appvd 6 swing beds. Before 2011,
hospital had 50 SNF beds; 2011 reduced the
SNF beds from 50 to 29; in 2013, reduced the
SNF beds from 29 to 16; in 2014, reduced the
SNF beds from 16 to 12.
printed 1/7/2020...12:11 PM 5 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Columbia Crest Center 1504 111 0 0 0 0 0 0 0 111
CN #1147 issued 6/11/96; 11/1/97 licensed
20 CN appvd beds; 4/6/98 name chg-formerly
Terrace Heights Nsg Care Ctr. 6/1/99 name
chg-formerly Sunrise Care & Rehab for
Moses Lake.06/01/05 31 beds banked. Ext of
31 beds 09-12; formerly SunBridge Care &
Rehab for Moses Lake. 31 beds conv 8/2010.
02/25/14 name change-formerly Columbia
Crest Care & Rehabilitation Center. 2/1/15
CHOW.
Coulee Community Hospital CLOSED 0 0 5 0 0 0 0 0 0October 2007, closed NH portion of facility;
did not bank 29 beds under FFC.
Lake Ridge Center 1506 74 0 0 0 0 0 0 0 74
9/9/94 Sunrise Health new operator; 4/6/98
name chg-formerly Lake Ridge Care Center.
6/1/99 name chg-formerly Sunrise Special
Care Center - Lake Ridge; formerly SunBridge
Special Care Center - Lake Ridge; name
change formerly Lake Ridge Solana
Alzheimers Care Center. 2/1/15 CHOW .
McKay Healthcare & Rehab Center 867 42 0 0 0 0 0 0 0 42 10/1/98 name chg-formerly McKay Memorial
Quincy Valley Hospital N/A 0 0 5 0 0 0 0 0 0
CN #802 appvd 6 swing beds (5 are exempt,
& 1 is counted as SNF bed); CN #921 appvd
22 bed SNF. 12/31/07 NH closed.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR GRANT 239 0 16 0 0 0 0 0 239
Grays Harbor Health and Rehabilitation
Center 1356 105 0 0 0 0 0 0 0 105
1/96 formerly Grays Harbor Convalescent
Center; 7/1/95 bank 18 beds-DSHS delic. 19
beds prior to CN approval-lost 1 bed. 10/1/98
bank 14 beds. 7/1/99 extension denied, lost
18 beds. 3/1/01 banked 1 bed. 10/1/02-6
beds extended, 9 forfeited.12/01/03 CHOW-
Avalon Care Center Aberdeen, 6 banked
beds forfeited. BB09-25 banking of 16 beds.
03/04/13 4-year extension on AU banking of
16 beds. 06/01/17 16 AU banked beds
relinquished=license remains at 105.
Mark Reed Hospital N/A 0 0 5 0 0 0 0 0 0 1/27/83 approved for 5 swing beds
Montesano Health and Rehabilitation 1530 94 0 0 0 0 0 0 0 94
CN #970 replace 37 bed Edgewood and add
23 beds to rename Hillview Care Ctr; CN
#970A cost amendmt., replace 37 bed
Edgewood and 34 bed Woodland Terrace
and add 23 beds; 7/3/97 MDC cert-lic. 94
beds; 9/1/98 name chg-formerly Montesano
Med & Rehab Ctr.6/1/99-name chg from
Sunrise Care & Rehab for Montesano.
05/01/04 CHOW, licensee is CPL Delaware-
named changed from Sunbridge Health and
Rehab for Montesano. 12/1/15 CHOW
Pacific Care and Rehabilitation 1477 109 0 0 0 0 0 0 0 109
2/95 change operator; 6/1/98 owner chg.
11/1/00 CHOW. 08/01/03 CHOW.05/01/2004-
9 beds relinquished. CHOW 8-1-06 New
Operator: Hoquiam Healthcare, Inc. Formerly
Hoquiam Helathcare dba Pacific Care Center.
9/3/14 CHOW for licensing only.
-------- -------- -------- -------- -------- -------- -------- -------- --------
printed 1/7/2020...12:11 PM 6 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
BED COUNT FOR GRAYS HARBOR 308 0 5 0 0 0 0 0 308
Careage of Whidbey 1094 112 0 0 0 0 0 0 0 112
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR ISLAND 112 0 0 0 0 0 0 0 112
LifeCare Center of Port Townsend 1196 94 0 0 0 0 0 0 0 94
6/1/96 Life Care Centers purchased as limited
partnership. 03/01/03-19 BB. 7/15/03 forfeit 2
beds-17bb. 01/23/04 Order to reinstate 2
beds forfeited and convert all 19 beds
effective 12/31/03. 12/14/04 19 beds banked
03/01/03 rebanked-38 months remaining on
initial time. Part of March 2007 Settlement -
BB Ext BB-08-07 - Conversion of 19 beds
requested, approved, then withdrawn by
facility 12/2008 - Name change 5/2010 former
Kah Tai Care Center
Jefferson General Hospital N/A 0 0 5 0 0 0 0 0 0 Swing Beds 9/11/02
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR JEFFERSON 94 0 5 0 0 0 0 0 94
Anderson House CLOSED 0 0 0 0 0 0 112 0 11206/30/17 CLOSED. 08/17/17 FFC bed
banking 06/30/25
Avalon Care Center-Federal Way 1355 120 0 0 0 0 0 0 0 120
6/30/95 bank 14 beds; RA #015 issued
8/18/97 - lost 14 banked beds per RA;
4/27/98 CN #1176 issued to add 50 beds to
replacement facility formerly known as
Monarch Care Center. 7/02 project
authorized by CN #1176 was downsized-only
24 beds were added (rather than 50 beds) for
a facility total of 120 at project
completion.12/17/03 CHOW aka Beverly
Health & Rehab of Federal Way. Change in
Landlord 12/01/03-12/31/03 TOGII, LLC;
effective 01/01/05=The ARBA Group-no
change in ownership lease in facility file.
Bailey-Boushay House 1106 35 0 0 0 0 0 0 0 35
Ballard Center 1503 142 0 0 0 0 0 0 0 142
7/1/96 banked 61 beds; 7/1/97 convert 5
beds; 7/1/97 bank 4 beds; 11/15/99 bank 8
beds; 5/16/00 lost 47 beds because good
cause for extension not shown; 13 beds
extended to 7/1/04; 10/1/00 banked 8 beds.
10/02-4 beds forfeited, 17 converted back.
CHOW 03/01/03 from Integrated Health
Services. 3/1/03-17 BB - Name change
from Whittier to Ballard - 2 Beds lost for
Inappropriate use approx 3/06 - 15 beds
lost March 1, 2007 for Timeliness of BB;
04/23/2014 name changed formerly Ballard
Care and Rehabilitation Center. 2/1/15
CHOW.
Bayview Manor 461 50 0 0 0 0 0 0 0 50
Benson Heights Rehabilitation Center 1363 91 0 0 0 0 0 0 0 91 12/01/03, CHOW-Avalon Care Center Kent
printed 1/7/2020...12:11 PM 7 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Briarwood at Timber Ridge [Type A
CCRC] 1413 0 45 0 9 0 0 0 0 0
Type A CCRC. CN 1312 approved 07/07/05
for Talus facility for 36 bed NH. 05/13/13 CN
#1503 issued to Horizon House to unbank 56
FFC beds and relocate them at this site. At
completion, Type A CCRC is closed and the
new facility [Briarwood Health Care] is a
community based nursing home. CN #1503
RELINQUISHED ON 06/03/14. FFC BEDS
ARE ALSO EXPIRED. TYPE A CCRC OF
BRIARWOD REMAINS AS TYPE A NH.
12/22/14 add 9 more typeA CCRC beds for a
facility total of 45.
Burien Nursing and Rehabilitation Center 1583 140 0 0 0 0 0 0 0 140
1/96 change owners; name chg-formerly
Burien Nursing Center; 29 beds banked
11/01/98. Name change, formerly Burien
Terrace. Extended 29 beds to 11/01/06.
3/12/03-Converted 5 beds - Converted 24
beds (07-06 & 07-34) effective Oct 31, 2007.
Formerly Life Care Center of Burien. 08/23/18
CHOW no name change.
Canterbury House 1269 100 0 0 0 0 0 0 0 100
7/18/97 name chg-formerly Canterbury
House; 10/1/98 CHOW; 4/01/01 name chg-
back to Canterbury House from Canterbury
Rehab
Caroline Kline Galland Home (The) 658 205 0 0 0 0 0 0 0 205
Columbia Lutheran Home 48 116 0 0 0 0 0 0 0 116
4/16/98 bank 6 beds; 3/15/00 CN #1205
issued for a post completion renovation
project. Extension denied-forfeited 6 beds.
Corwin Care Center at Emerald Heights
Type A CCRC 1113 0 61 0 0 0 0 0 0 0
4/1/94 name change; 10/1/97 bank 2 beds;
5/1/98 bank 2 beds Note: these banked beds
are not counted in the banked bed supply
because the facility's beds total beds are not
counted in county supply.
Covenant Shores Health Center 1231 43 0 0 0 0 0 0 0 43 CN #1090 issued 6/3/93
Cristwood Nursing and Rehabilitation 274 168 0 0 0 0 0 0 0 168
AU 06-60 - Banked 8 beds - name changed
from Crista Senior Community - Ext 8 beds
BB10-12. Voluntary relinq of 8 beds 12/11
Enumclaw Community Hospital N/A 0 0 5 0 0 0 0 0 0 Swing Bed App Rcd 6-24-2005
Enumclaw Health and Rehabilitation
Center 1266 92 0 0 0 0 0 0 0 92
8/1/96 chg owner (Unison HC); name chg-
formerly Franciscan HC Ctr @ Enumclaw;
11/1/96 bank 20 beds; 11/1/96 bank 3 beds;
6/1/98 convert 23 beds; 8/1/98 owner/name
chg-formerly Enumclaw HC & Rehab Ctr.
11/9/98 banked 31 beds. 11/9/02-extend 30
beds, 1 forfeited. Expires 11/9/06 (can't be
extended).09/01/03 25 beds banked, exp
9/1/07. Conv 30 beds 7-31-06 - lost 25 beds
in expiration of 4 yr BB - Voluntary reduction
of 30 beds effective 1/1/09
Foss Home and Village 417 211 0 0 0 0 0 0 0 211
printed 1/7/2020...12:11 PM 8 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Garden Terrace Healthcare Center of
Federal Way 1350 70 0 0 0 0 0 0 0 70
7/1/94 Cascade Care Centers = new
operator; 1/5/96 RA#004 replaces bldg.-fac.
closed until completed.10/01/03 New
Licensee- Federal Way Medical Investors.
08/01/15 name changed from Garden Terrace
Alzheimer's Center of Excellence. 2018 name
change; formerly Garden Terrace Alzheimer's
Center of Federal Way.
Hallmark Manor 1076 147 0 0 0 0 0 0 0 147
11/9/98 banked 18 beds. 8/23/00 approved to
convert 18 beds back to SN use. 09/1/00
banked 12 beds. 11/1/01 Banked 8
beds.06/28/04 Loss of 8 beds during
conversion request, awaiting license
modification Part of March 2007 Settlement -
Modified 2 beds May 2007 - BB08-19
Conversion of 5 beds - BB09-07 conv
remaining 3 beds
Health and Rehabilitation of North Seattle CLOSED 0 0 0 0 0 0 119 0 119
9/1/03-Name Change from Greenwood Park
Care Center.9/1/03 15 beds banked-exp
9/1/07.Relinquish 6 beds banked 09/01/03.
relinquished another 17 beds 10/12/05 to
revise total - loss of 9 beds with BB
expiration. 01/22/18 FFC bed banking for 119
beds. 01/22/26
Hearthstone, The 527 40 0 0 0 0 4 0 0 44
7/8/97 RA#014; 6/1/97 bank 7 beds.
Reminder mailed 1/18/01 for 7 beds banked
6/1/97. 3/5/01, extension granted for 7 beds
to 6/1/2005.Loss of 7 beds banked 06/01/97.
02/24/17 BB #17-02, AU bank 4 beds. 02/24/21
Highline Community Hospital CLOSED 0 0 0 0 0 0 30 0 30
CN #1097 10/4/93; reduce beds by 9 to NW
Reg Resp & Complex Care Consort. 04/2/12
FFC bed banking for 30 beds. 04/02/20
Ida Culver House Broadview Nursing
Care Center 1065 74 0 0 0 0 0 0 0 74
Issaquah Nursing and Rehabilitation
Center 1582 140 0 0 0 0 0 0 0 140
7/1/98 oper chg. 12/4/98 banked 2 beds.
3/1/00 CHOW- lost 2 beds. Previously named
Issaquah Care Center & The Gardens at
Issaquah - License cites Issaquah Nursing &
Rehab Ctr - Voluntary relinquishment of 40
beds 7/2009. 08/23/18 CHOW no name
change.
Judson Park Health Center 797 96 0 0 0 0 0 0 0 96
3/1/96 - bank 4 beds; 1/1/00 4 year extension
on 4 beds to 3/1/04. 12/31/01 banked 16
beds. Relinquished an additional 12 beds. 4
beds banked on 3/1/96 forfeited, untimely
request.12/29/04 conversion of 8 bb. Extend
8 beds -expire 12/31/09. 8 beds lost in BB
exp
Keiro Northwest CLOSED 0 0 0 0 0 0 150 0 150
4/1/96 RA#007. 10/07/16 name change-
formerly Seattle Keiro. BB20-04 -- Full
Facility closure 9/12/2019. On September 12,
2019, 150 beds banked. 09/12/27
Kin On Health Care Center 1221 100 0 0 0 0 0 0 0 100
CN# 1082 minority beds owned by Chinese
Nursing Home Society; 6/17/94 name chg per
HUD req's. (formerly Kin On Nursing Home
operated & leased 63 beds from Nikkei
Concerns dba Seattle Keiro)
printed 1/7/2020...12:11 PM 9 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Lea Hill Rehabilitation and Care Center 1551 36 0 0 0 0 0 0 0 36
CN #1534 issued on 10/06/14 approved the
establishment of a 36-bed M/M nursing home.
The 36 beds came from the FFC banked
beds at Bessie Burton Sullivan. CN #1534R
issued on 05/15/15 reduced the capital
expenditure but the number of beds remain at
36. 08/18/17 name change-formerly Skilled
Nursing Facility Managed by Wesley Homes.
Life Care Center of Kirkland 1419 190 0 0 0 0 0 0 0 190
6/1/96 Life Care Centers purchased as limited
partnership. Chow 1/09 aka Lake Vue
Gardens Convalescent Center
Life Care Center of West Seattle CLOSED 0 0 0 0 0 0 106 0 106
5/96 LifeCare purchased as limited
partnership; formerly Moderncare West
Seattle. 11/1/98 banked 21 beds; 8/23/00
approved to convert 21 beds back to SN use.
9/1/00 banked 21 beds. 2/11/02 unbank 5
beds. 4 beds converted from 9/1/00.3/16/03-
converted 5 BB.11 beds remaining banked
extended to 11/01/06-no further extensions.
Part of March 2007 Settlement - Modification
of 2 May 2007 - remain at 11 BB - Conv 11
beds BB08-24. 12/19/12 FFC BED BANKING 12/19/20
Life Care Center of Federal Way 1107 157 0 0 0 0 0 0 0 157
11/12/98 banked 18 beds; formerly Federal
Way Convalescent Center; 8/23/00 approved
to convert 18 beds back to SN use. 9/1/00
banked 18 beds.18 beds extended to
November 1, 2006. Part of March 2007
Settlement - Conv 18 beds BB08-23
Mercer Island Care and Rehabilitation
Center CLOSED 0 0 0 0 0 0 0 100 0
4/7/98 name chg-formerly Mercer Island Care
Ctr. 10/01/03-8 beds banked. Ext 8 beds 07-
48; BB exp of 8 beds 10-1-11. 5/1/13 CHOW
07/03/14 FACILITY CLOSED; 100 BEDS
BANKED UNDER FFC. See facility file b/c
both licensee & building owner banked beds.
See also M2015-1165 & King County judicial
review #16-2-21779-6 SEA 07/03/22
Mirabella 1501 46 0 0 0 0 0 0 0 46
11/14/06- CN 1341 approved 22 bed Type A
CCRC; facility opened December 2008; 5-
year transition ends December 2013.
02/14/14-CN #1524 issued to change from a
Type A CCRC NH to a community based
nursing home, with Seattle University as the
licensee. Facility to have a total of 46 beds
[phase 1=22; phase 2=24]. Phase 2
complete & license issued for 46 beds on
9/9/14. Formerly Mirabella-a type A CCRC
NH.
Mission Healthcare at Bellevue 1365 69 0 0 0 0 0 0 0 69
7/14/94 CN #1106 - replaces Bellevue Care
Center; licensee is Living Services, Inc.;
8/27/96 RA #011 - redist 59 beds from
Laurelwood Care Ctr; 3/1/97 merge floor 1&2;
3/01 name change formerly Eastside Medical
& Rehab. RA#088 reduces Mission
Healthcare at Bellevue's # of beds from 129
to 69.
printed 1/7/2020...12:11 PM 10 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Mission Healthcare at Renton 1584 60 0 0 0 0 0 0 0 60
RA #088 issued on 10/04/16 approves the
replacement of 60 beds from Mission
Healthcare at Bellevue to this new site in
Renton. RA#088 reduces Mission Healthcare
at Bellevue's # of beds from 129 to 69.
North Auburn Rehabilitation and Health
Center 1556 125 0 0 0 0 0 0 0 125
5/95 name change; formerly Green River
Terrace Nursing Center; 6/30/95 bank 12
beds; 7/1/96 bank 9 beds. 7/1/99 extend 12
beds originally banked on 7/1/95 to 7/1/03.
7/1/00 forfeit 9 beds (letter sent 6/15/00);
5/4/01 modify use of 12 beds.4/8/03-Forfeit 5
beds, ineligible usage. Converted BB. 7/1/15
CHOW. 12/01/17 CHOW.
Paramount Rehabilitation and Nursing 1540 165 0 0 0 0 0 0 0 165
CHOW 04/02/03-aka Branch Villa. 06/27/03-
Relinq 5 beds. 5/31/04-Relinq 32
beds06/01/04 35 beds banked. 12/01/04-
Relinquished all 35 beds 12/1/04. 09/26/16
CHOW-formerly Leon Sullivan Health Care
Center.
Park Ridge Care Center 1581 115 0 0 0 0 0 0 0 115
10/7/96 bank 13 beds; 10/16/98 CHOW-lost
13 banked beds.10/01/03-CHOW-Northwest
Care-Shoreline, Inc. 08/23/18 CHOW no
name change.
Park Shore 489 28 0 0 0 0 0 0 0 28
9/1/94 lost 4 beds - delic w/DSHS - DOH did
not rec. bed bank req. - RA#059 transfers 2
beds to The Terraces at Skyline - also
involves Exeter
Park West Care Center 1580 137 0 0 0 0 0 0 0 137
1/1/97 banked 13 beds; 10/16/98 CHOW-lost
13 banked beds. 10/01/03 CHOW- Northwest
Care-West Seattle.01/26/04 2 beds banked.
1/26/08-2 banked beds expired. 08/23/18
CHOW no name change.
Providence Marianwood 1177 117 0 0 0 0 0 0 0 117
1/96 change of owner-Sisters of Providence;
1/16/97 name chg-formerly Marianwood -
Voluntary relinquishment of 3 beds 3/2012
Providence Mount St. Vincent Nursing
Center 77 215 0 0 0 0 0 0 0 215
CN #1096 issued 10/1/93 transferred 27 beds
to Providence Medical Center; Mt St Vincent
downsized by 37 beds; 11/95 antic completion
date. 8/2/99 - total of 215 SNF beds (Mt. St.
Vincent=173 & St. Joseph Residence=42).
2/17/00 RA #030 issued for renovation of Mt.
St. Vincent
Queen Anne Healthcare 1459 120 0 0 0 0 0 0 0 120
5/26/95 formerly Queen Anne Care Center;
6/26/95 bank 3 beds; 7/1/98 CHOW - forfeit 3
banked beds. 10/1/98 banked 41
beds.10/1/02-extended 35 beds, 5 lost Letter
cites 6); can't extend. - Loss of 35 beds
2/2007 with expiration - voluntary delicensing
of 10 beds 6-4-08. FORMERLY Queen Anne
Healthcare; FORMERLY Kindred Transitional
Care & Rehabilitation-Queen Anne.
FORMERLY Avamere Transitional Care and
Rehabilitation-Queen Anne
Redmond Care and Rehabilitation Center 1462 139 0 0 0 0 0 0 0 13912/01/13 CHOW-formerly Cascade Vista
Convalescent Center, Inc.
printed 1/7/2020...12:11 PM 11 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Advanced Post Acute 1544 96 0 0 0 0 0 0 0 96
6/1/96 Life Care Centers purchased as limited
partnership; 5/1/97 Name chg-formerly
Applegate Care Center - Chow Application 8-
1-06 to change - Formerly Life Care of Auburn
- New Licensee Regency Auburn as of
11/1/06; CHOW 03/01/17 formerly Regency
Auburn
Regency North Bend Rehabilitation and
Nursing Center 1431 64 0 0 0 0 0 0 0 64
7/1/95 bank 2 beds; 5/1/96 chg owner; name
chg-formerly North Bend Nsg Ctr; lost 2 beds
per CHOW. 5/1/98 banked 12 beds. 6/22/00
CN #1209 issued to add 10 beds to Forest
View from Mt. Si Transitional Health Center.
At project completion, Forest View = 70 & Mt.
Si = 76 licensed & 12 banked. 2/28/01
project authorized by CN #1209 complete. 12
Beds banked April 1, 200. Forfeited 12 beds
that expired on 5/1/02, also lost 6 beds for
non allowable AU. Convert 2 beds.
Conversion request (11/01/03) of 6 bb did not
take place=6 beds remain banked.6
remaining banked beds extend to 04/01/09-
cannot be extended further. 6 beds lost 4/09
with the expiration of BB. 04/15/15 name
change-formerly Mount Si Transitional Health
Center
Renton Nursing and Rehabilitation Center 1554 99 0 0 0 0 0 0 0 99
7/10/95 bank 17 beds, 11/1/98 bank 24 beds.
7/10/99 four year ext. appr. for 17 beds,
expire 7/10/03. 07/01/01 bank 20
beds.11/1/02-extend 19 of 24 beds, 5 lost,
can't extend. 17 beds banked 07/10/03
forfeited.03/01/05, CHOW, loss of 39 BB.
02/2013 name change formerly Regency at
Renton Rehab Center. 10/1/17 CHOW w/ no
name change
Richmond Beach Rehab 1346 140 0 0 0 0 0 0 0 140
4/7/98 name chg-formerly Richmond Beach
Med & Rehab Ctr. 6/01/99 name chg-formerly
Sunrise Care & Rehab for Richmond
Beach.7/1/03-CHOW from Sunbridge at
Richmond Beach.
Sea Mar Community Care Center 1161 48 0 0 0 0 0 0 0 48
7/1/96 banked 35 beds;12/1/97 convert 10
beds. 11/1/99 convert 2 beds; 1/13/00
convert 3 beds; 3/23/00 convert 6 beds;
3/23/00 4-yr extension on remaining 14 beds
to 7/1/04. March 22, 2001 convert 6 beds 8
beds remaining. 08/30/04 8 beds converted.
10/24/17 voluntarily relinquished 52 NH beds
with no bed banking.
Seattle Medical Post Acute Care 1228 103 0 0 0 0 0 0 0 103
7/1/95 bank 23 beds; 1/1/97 convert 23 beds;
5/1/97 name & owner chg-formerly Phoenix
Rehab; 2/1/98 bank 40 beds; 9/14/99 lost 40
banked beds due to change of ownership.
2/2013 name change formerly Seattle Medical
& Rehab Center
printed 1/7/2020...12:11 PM 12 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Shoreline Health and Rehabilitation 1526 114 0 0 0 0 0 0 0 114
3/31/95 voluntary reduction of 33 beds;
6/30/95 bank 17 beds convert date extend to
6/30/01 per Order - addtl 2 yr extend to
6/30/03. 10/1/98 banked 35 beds.5/1/02 13
BB.10/1/02-extended 35 banked beds.
Forfeited 17 banked beds from
6/30/95.Extend 13 beds banked 06/30/01to
06/30/09, cannot be extended. Loss of 1 bed
(room 109) and extended remaining 12
eligible. 9/30/06-35 AU beds expired & lost -
Conv of 12 beds BB09-22 (corrected letter)
name changed from Pinehurst Park Terrace.
10/01/15 CHOW name changed from
Shoreline Health & Rehabilitation Center.
Snoqualmie Valley Hospital N/A 0 0 25 0 0 0 0 0 0 8/31/09 increased swing beds from 5 to 25
Saint Anne Nursing and Rehabilitation
Center 1323 47 0 0 0 0 0 0 0 47
4/1/94 name change 9/1/01 CHOW - new
licensee St. Anne Corp; Formerly
Meadowbrook Nursing Home.
Stafford Healthcare 1364 165 0 0 0 0 0 0 0 165
2/14/00 banked 25 beds for AU. 12/17/03-
CHOW aka Seatoma, 25 Banked Beds
forfeited.02/02/04-New Licensee, Stafford
Healthcare, SeaTac, LLC,. 07/01/05
relinquished 75 beds.
Sunrise Haven 1315 8 0 0 0 0 0 0 0 8
10/6/97 voluntarily reduced license from 24 to
18; 10/6/99 voluntarily reduced license from
18 to 10; 1/10/01 voluntarily reduced license
from 10 to 8;
Talbot Center for Rehabilitation and
Healthcare 1573 136 0 0 0 0 0 0 0 136
6/1/97 name chg-formerly Renton Rehab &
Healthcare; 7/1/98 oper chg; 9/1/00 CHOW to
Evergreen at Talbot Road, LLC; 10/9/00 bank
31 beds.04/19/04 forfeited 4 beds, non
allowable under AU.08/03/04 1 bed
converted.10/01/04-final extension for
remaining 26 bb. Voluntary forfeiture of 26
banked beds in Oct, 2008. 05/14/18 CHOW
Terraces at Skyline (The) 1440 34 0 0 0 0 0 0 0 34
NH under construction - Tentative Name - RA
059 transfers 32 beds from Exeter (closing)
and 2 from Park Shore
The Kenney CLOSED 0 0 0 0 0 0 20 0 20
09/01/93 -18 beds to alt use (possibly
boarding home use); 01/01/95- 6 beds to alt
use (possible boarding home use); lost 18
beds, banking expired before dept rcvd req. to
convert; 1/28/98 unbank 6 beds. 02/21/18
closed & FFC bed banking 01/10/26
The Oaks at Forest Bay 1567 90 0 0 0 0 0 0 0 90
5/1/98 terminating MCaid contract; 7/1/98
oper chg. 2/1/99 forfeited 10 beds for not
meeting Medicaid standards, per DSHS letter
of 2/10/99. Formerly Arden Rehab and
Healthcare Center. 12/20/17 CHOW.
Formerly Kindred Nursing and Rehabilitation-
Arden
The Springs at Pacific Regent 1532 54 0 0 0 0 0 0 0 548/1/96 chg owner (Fountains Affiliated Co.s).
12/1/15 CHOW
Vashon Community Care Center CLOSED 0 0 0 0 0 0 0 30 0
6/26/95 banked 12 beds; formerly Island
Manor Nsg Ctr. 8/1/98 banked 3 beds.
CHOW forfeit 12 beds. 1/14/00 banked 3
more beds. 01/15/04, forfeited 6 banked
beds.
07/31/19 - FFC-BB effective date of closure
for 30 beds. 07/30/27
printed 1/7/2020...12:11 PM 13 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Washington Center for Comprehensive
Rehabilitation 1394 165 0 0 0 0 0 0 0 165
6/30/95 bank 10 beds; 2/7/96 banked 19
beds; 7/15/97 name chg-formerly Restorative
Care Center. 4/28/99 RA #021R issued for
replacement of Washington Center with a 179
bed SNF. 6/30/99 extension denied, lost 10
beds. 6/28/99 apprvd extension of 19 banked
beds to 2/7/04. 5/1/01 convert 19 beds back
to skilled use. 8/13/01 banked 14 beds. 14
beds banked 08/13/01 lost, none remaining.
New Licensee: Washington Care Services
Wesley Homes Health Center 1382 148 0 0 0 0 0 0 0 148
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR KING 5,410 106 30 9 0 4 537 130 5,960
Bainbridge Island Health and
Rehabilitation Center 1510 69 0 0 0 0 0 0 0 69
6/30/95 bank 6 beds; 12/95 formerly Winslow
Convalescent Center; 7/1/96 banked 3
beds;7/1/97 bank 5 beds. Extended 6 beds
banked on 7/1/95 to 7/1/2003 (these bed
cannot be extended for another 4 years).
8/1/99 banked 10 beds. 8/1/00 3 beds
forfeited (letter sent 6/21/00); Reminder
mailed 1/18/01 for 5 beds banked 7/1/97;
3/29/01 extended 5 beds banked on 7/1/97 to
7/1/2005. 07/14/01 banked 2 beds.5/1/02-
converted 6 beds.4/8/03 2 BB. 8/1/03 last
extension for 10BB. 7/1/03-relinquish 1BB.
05/24/05 convert 4 beds. Extend 2 beds
banked on 07/14/01 to 07/14/09-can't extend -
Asked to ext 3 (BB07-18), extended 2 -
differed 1 back to them - Converted 19
March, 2007 Awaiting ALM - ALM received
for 88 - immediately relinquished 19 bed count
remains at 69. 05/01/15 CHOW formerly
lsland Health and Rehabilitation Center
Bremerton Convalescent and
Rehabilitation Center 1558 125 0 0 0 0 0 0 0 125
11/94 change of owner; 6/30/95 bank 6 beds;
7/1/96 banked 7 beds. 7/1/99 extend 6
banked beds of 6/30/95 to 6/30/03. 8/1/99-
3BB. 7/1/00 forfeit 7 beds (letter sent
6/15/00). 8/29/01 Name change, now
Bremerton Health 7 Rehab. 8/1/03, extend
beds banked 8/1/99.07/18/03 3 beds
relinquished, 3 beds converted.11/02/04 3
beds converted, no beds remain banked.
7/1/15 CHOW-formerly Bremerton Health &
Rehabilitation Center. 12/01/17 CHOW
Forest Ridge Health and Rehabilitation
Center 1560 98 0 0 0 0 0 0 0 98
11/94 Change of owner; 3/1/97 name chg;
8/1/97 bank 15 beds; 9/11/00 convert 7 beds
; 8 remain banked; reminder mailed 1/18/01
for 8 beds. 3/29/01 extended 8 beds banked
on 7/1/97; new expn is 7/1 05 (these beds
cannot be extended for another 4
years.)10/21/03-2 beds converted. 12/29/04 4
beds converted, 2 remain banked. 05/18/05 2
beds converted. 7/1/15 CHOW. 12/01/17
CHOW.
Life Care Center of Port Orchard 1418 125 0 0 0 0 0 0 0 1256/1/96 Life Care Centers purchased as limited
partnership; name change
Martha and Mary Health Services 1216 190 0 0 0 0 0 0 0 190
printed 1/7/2020...12:11 PM 14 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Messenger House Care Center CLOSED 0 0 0 0 0 0 96 0 96
05/31/18 Closed; 06/12/18 sent letter
informing of FFC bed banking. 07/06/18 FFC
beds banking-96 beds 06/01/26
Northwoods Lodge 1589 57 0 0 0 0 0 0 0 57
3/4/94 bank 13 beds; 7/1/94 Medicaid cert.
3/24/96 reinstated 6 banked beds; 9/26/97
granted 4 yr bank ext.-expire 3/4/02. 1/7/99
convert 3 beds back. Forfeited banked beds.
03/01/17 CHOW. 11/28/18 CN1753 approve
the unbanking of 10 banked beds and
addition to capacity
Stafford Healthcare at Belmont 575 102 0 0 0 0 0 0 0 102 Name changed formerly Belmont Terrace
Stafford Healthcare at Ridgemont 588 96 0 0 0 0 0 0 0 96
8/15/96 banked 5 beds; 6/21/00 4 year extn
on 5 beds to 8/15/2004. 8/15/2004-45 beds
forfeited, no banked beds. Name changed
formerly Ridgemont Terrace
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR KITSAP 793 0 0 0 0 0 96 0 889
Kittitas Valley Community Hospital N/A 0 0 5 0 0 0 0 0 0
Prestige Post-Acute and Rehabilitation
Center-Kittitas 1468 74 0 0 0 0 0 0 0 74
7/26/95 formerly WHC-Gold Leaf; 10/1/95
formerly Kittitas Valley Regional Rehabilitation
Center; 7/1/96 banked 6 beds; 7/1/00 forfeit 6
beds (letter sent 6/15/00). 09/22/14 CHOW
formerly Kittitas Valley Health & Rehabilitation
Center.
Royal Vista Nursing & Rehab 1344 0 0 0 0 0 0 67 0 67
7/1/95 bank 4 beds. 7/1/99 extension request
denied, lost 4 beds.5/1/03 CHOW. 06-59 -
banked 15. Ext of 15 BB10-03 - Voluntary
Relinqishment of 15 beds 6/2010. 08/20/15
FFC bed banking for 67 beds [BB16-01] 08/20/23
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR KITTITAS 74 0 5 0 0 0 67 0 141
Klickitat Valley Hospital N/A 0 0 25 0 0 0 0 0 01/6/10 increased swing beds from 5 to 15;
8/2/10 increased swing beds from 15 to 25.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR KLICKITAT 0 0 25 0 0 0 0 0 0
Prestige Post-Acute and Rehabilitation
Center-Centralia 1469 128 0 0 0 0 0 0 0 128
1/1/94 name change; 9/1/13 CHOW.
09/01/14 CHOW formerly Liberty Country
Place. 4/1/15 name change-formerly Prestige
Post-Acute and Rehabilitation Center-Liberty
printed 1/7/2020...12:11 PM 15 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Riverside Nursing and Rehabilitation
Center 1559 91 0 0 0 0 0 0 0 91
06/29/94 banked 10 beds; 6/30/95 bank 18
beds; 7/1/96 banked 14 beds; 7/1/97 bank 6
beds; 6/29/98 extend banking of 10 beds
originally banked on 6/29/94 to 6/29/02 (these
10 beds cannot be extended another 4
years). 7/1/99 extend banking of 18 beds
originally banked on 7/1/95 to 7/1/03 (these
18 beds cannot be extended another 4
years). 7/1/00 forfeit 14 beds (letter sent
6/15/00); reminder mailed 1/18/01 for 6 beds
banked 7/1/97; 3/29/01 extended banking for
6 beds banked 7/1/97 to 7/1/05 (these 6 beds
cannot be extended another 4 years).
07/14/01 banked 3 beds. 08/01/01 banked 5
beds. Forfeited 10 beds banked 6/29/94.
Relinquished 10 beds expiring on 6/29/02.
Converted 8 BB. 14 beds remain banked
04/21/04 6 beds converted, 8 beds remain
banked. Relinquished 6 beds banked
07/01/97, 2 remain banked. 2 beds banked
expire on 08/01/09 - 2 beds conv 4/09.
12/01/17 CHOW.
Sharon Care Center 1304 42 0 0 0 0 0 0 0 427/1/00 CHOW (additional corporate owners
added)
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR LEWIS 261 0 0 0 0 0 0 0 261
Lincoln Hospital CLOSED 0 0 5 0 0 0 35 0 35
Banked 3 beds 3/3/00.Loss of 3 banked
beds. 05/23/12 banked 35 SNF beds under
FFC. 05/23/20
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR LINCOLN 0 0 5 0 0 0 35 0 35
Fir Lane Health and Rehabilitation Center 1564 135 0 0 0 0 0 0 0 135
formerly Fir Lane Terrace Convalescent
Center; 8/1/99 banked 9 beds. 7/14/01-15
BB, Extend beds banked 8/1/99 to 8/1/07 (no
extension poss).01/20/04 1 banked bed
forfeit, not AU purpose. 03/04/05-Loss of 6
banked beds per DSHS survey findings-17
beds remain banked. Extend 14 beds banked
07/12/01 to 07/12/09=not able to extend. 17
banked beds relinquished as part of approval
of CN07-04. 7/1/15 CHOW. 12/01/17
CHOW.
Shelton Health and Rehabilitation Center 1324 76 0 0 0 0 0 0 0 76
2/1/99 name chg-formerly Exceptional
Foresters Care Center 9/1/01 CHOW and
name change. Formerly Sunbridge Care &
Rehab for Shelton
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR MASON 211 0 0 0 0 0 0 0 211
North Valley Hospital N/A 42 0 5 0 0 0 0 0 42
8/28/00 approval for 5 swing beds. 04/18/05-
relinquish 18 beds-request rescinded. 11/2/06
banked 10 and relinquished 2- relinqushed
remaining 10 BB 6/1/2010. 09/24/14
reliquished 16 beds [from 58 to 42]
printed 1/7/2020...12:11 PM 16 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Okanogan County PHD #3-Mid-Valley
Hospital N/A 0 0 5 0 0 0 0 0 04/19/85 approval for 5 swing beds
Regency Harmony House Rehabilitation
and Nursing Center 1536 54 0 0 0 0 0 0 0 54
6/30/95 banked 5 beds. 10/21/98 banked 3
beds; 10/1/99 extend 5 beds to 10/1/03;
5/15/00 bank 8 beds and relinquish rights to 3
beds; 12/20/00 RA #033 issued for the
renovation of Harmony House; at time of
issuance, 54 licensed beds and 16 banked
beds. 11/01/01 unbank 6 beds. 2/1/02
banked 6 beds AU. Forfeited 8 beds banked
from 6/30/95, 10/01/98. 8 beds remaining
banked. 05/01/04 Forfeiture of 2 banked beds-
6 beds remaining. 02/01/05, loss of all 6
banked beds. 06/01/16 CHOW formerly
Harmony House Health Care
Regency Omak 1479 56 0 0 0 0 0 0 0 56
7/1/95 bank 2 beds, 10/1/98 bank 8 beds.
5/31/99 convert 10 beds. CHOW. 7/1/99
banked 27 beds. 4/1/01 banked 12 beds.
Forfeited 27 beds banked on 7/1/99. 04/01/05-
12 beds banked on 04/01/01 extended-cannot
be extended again. Loss of 12 beds 2/09 due
to missed conv application - Settlement
replaced 6 of 12 lost beds 5/1/10. RA #070
issued to replace Valley Care Center at a new
site in Omak. CHOW 11/01/14 formerly
Valley Care Center.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR OKANOGAN 152 0 10 0 0 0 0 0 152
Ocean Beach Hospital N/A 0 0 15 0 0 0 0 0 0
Willapa Harbor Health & Rehab 1357 60 0 0 0 0 0 0 0 60
12/1/03 CHOW-Avalon Care Center
Raymond - Banked 20 beds 3/09 BB09-13 -
voluntary relinq of 20 beds 9/29/10. 7/1/12
name change from Willapa Harbor Care
Center
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR PACIFIC 60 0 0 0 0 0 0 0 60
Newport Community Hospital N/A 0 0 24 0 0 0 0 0 0
8/25/98 CN #1181 issued for post renovation
project. 05/30/14 increase swing beds from 5
to 24 [DOR14-25]. 08/01/19 Hospital closed
its 50 bed TCU and did not bank the beds
under FFC. 24 swing beds at CAH.
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR PEND OREILLE 0 0 24 0 0 0 0 0 0
Alaska Gardens Health and Rehabilitation
Center 1397 123 0 0 0 0 0 0 0 123
2/1/97 Franciscan Eldercare forming new
corp; 2/1/97 name chg-formerly Franciscan
HCC at Tacoma CHOW 8-1-06 new operator -
Evergreen at Tacoma LLC previously
Franciscan Health Care at Tacoma - Formerly
Tacoma Health & Rehab Center
printed 1/7/2020...12:11 PM 17 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Avamere at Pacific Ridge 1405 102 0 0 0 0 0 0 0 102
7/1/98 oper & name chg-formerly Tacoma
Terrace. 11/1/98 37 beds banked. 7/1/99
unbanked 37 beds. 12/15//00 bank 42 beds.
Extend 33, 9 beds forfeited=Per 05/14/04
Settlement Agreement: 38 beds extended,
5 forfeited with adjusted expiration date
03/28/03. Conv 08-10 of 40 beds effective
3/14/08 - Voluntary relinquish of 30 beds 4-1-
08 Formerly Tacoma Rehab - ext 10-06 of 3
remaining banked beds. Voluntary
relinqushment of 3 beds 8/2010. 01/01/15-
NAME CHANGE Formerly Avamere Skilled
Nursing of Tacoma.
Avamere Heritage Rehabilitation of
Tacoma 1403 89 0 0 0 0 0 0 0 89
7/1/98 oper chg; 7/24/98 name chg; 3/23/00
banked 19 beds. 05/03/01 unbanked 4 beds.
Extended 15 beds to12/15/07 (corrected date,
banked on 12/15/99) - Converted 15 BB-08-
01 RA #058 issued on 07/14/06 approving
renovation of the NH. 02/20/08 RA #058 was
relinquished without completion of the
renovations.
Avamere Transitional Care of Puget
Sound 1542 60 0 0 0 0 0 0 0 60
7/1/98 oper chg; Formerly Georgian House.
RA #080 issued on 12/12/14 approving
replacment facility. (Formerly Avamere
Georgian House of Lakewood) New name:
Avamere Transitional Care of Puget Sound.
With completion of RA #080A2 relinquished
13 beds; current license is 60.
Cottesmore of Life Care 1368 108 0 0 0 0 0 0 0 108
5/1/96 chng owner;12/6/96
Medicare/Medicaid certified per CHOW.
01/11/16 RA #084 issued for renovation;
10/07/16 RA #084R issued to correct error in
RA #084.
Franke Tobey Jones 452 43 0 0 0 0 0 0 0 43
Heartwood Extended Health Care 1308 120 0 0 0 0 0 0 0 120 8/1/00 CHOW;
Heron's Key [Type A CCRC] 1555 0 45 0 0 0 0 0 0 0 Type A CCRC nursing home
Life Care Center of Puyallup 1387 102 0 0 0 0 0 0 0 102
1/96 change owner; 11/1/98 banked 52 beds;
12/10/99 RA #028 issued for renovation of
Valley Terrace Nursing Center. name chg-
formerly Valley Terrace Nursing Center;
8/23/00 approved to convert 52 beds back to
SN use. 9/1/01 banked 52 beds. 10/01/01
banked 10 beds. Extend 52 beds expire
11/01/06-no extension. 10 beds banked
10/01/01 forfeited, notification not timely. Part
of March 2007 Settlement - BB08-21 conv 50
beds - BB09-09 Conv 3 beds - CBB09-27
CONV 9 BEDS. RA #075 issued for a new
facility in Puyallup using 100 of the 202
licensed beds. Project completion Life Care
Puyallup 102 beds; Life Care South Hill-100
beds.
Life Care Center of South Hill 1533 100 0 0 0 0 0 0 0 100 See RA #075
Linden Grove Health Care Center 1529 130 0 0 0 0 0 0 0 130
7/1/98 oper chg. 12/1/15 CHOW. Name
change: formerly Linden Grove Care Center
Manor Care Health Services (Gig Harbor) 1592 120 0 0 0 0 0 0 0 12011/1/95 CHOW; 1/21/07 CHOW; 08/05/18
CHOW. 01/01/20 CHOW
printed 1/7/2020...12:11 PM 18 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Manor Care Health Services (Tacoma) 1597 124 0 0 0 0 0 0 0 124
9/3/96 name chg-formerly Manor Care of
Meadow Park; 7/1/97 bank 1 bed; reminder
mailed 1/18/01; 4/5/01 4 year extension for 1
bed granted to 7/1/2005. Loss of bed banked
07/01/97. CHOW 12-21-07; 08/05/18
CHOW. 01/01/20 CHOW
Nisqually Valley Care Center CLOSED 0 0 0 0 0 0 63 0 63
05/22/18 Closed; 06/12/18 sent letter
informing of FFC bed banking. 07/06/18 FFC
beds banking-63 beds 05/23/26
Orchard Park Health and Rehabilitation
Center 1531 147 0 0 0 0 0 0 0 147
CN #1083 - 6/23/98 VOID-lost CN result of
CHOW; 7/1/98 oper chg. 6/9/15 name
change-formerly Orchard Park. 12/1/15
CHOW
Park Rose Care Center 1424 139 0 0 0 0 0 0 0 139
10/14/96 bank 12 beds; 10/16/98 CHOW-lost
12 banked beds; 9/13/00 approved to bank
44 beds on C wing. 5/1/03, additional 23
beds banked.44 beds extended to 8/8/08, no
extension for these. 4/1/07 23 beds expired &
lost. 8/8/08-44 beds expired & lost. [Loss of
67 beds (44+23)]
Puyallup Nursing and Rehabilitation
Center 1434 96 0 0 0 0 0 0 0 96
7/10/95 bank 26 beds. 11/1/98 bank 13 beds.
7/1/99 bed bank extension - 26 beds to
7/10/03. 7/1/01 banked 3 beds.11/1/02-
extend 13 beds, can't extend. 26beds banked
7/10/95 forfeited. 03/01/05-CHOW, loss of 13
BB. 02/2013 name change [formerly Regency
at Puyallup Rehabilitation Center]
Rainier Rehabilitation 1467 117 0 0 0 0 0 0 0 117
7/1/98 oper chg. Formerly Rainier Vista Care
Center Delicensed 3 beds 7/2010. 06/01/14
CHOW & name change-formerly Kindred
Transitional Care & Rehab-Rainier Vista
Rocky Bay Health Care Facility 822 30 0 0 0 0 0 0 0 30
Tacoma Lutheran Retirement Community 601 187 0 0 0 0 0 0 0 187
1/1/00 banked 31 beds. Forfeited 9 beds,
remaining 25 extended under AU. 03/01/04 2
BB, expire 03/01/08. 3/2008-Loss of 27(25+2)
expired banked beds . 11/01/17 name change-
formerly Tacoma Luther Home.
Tacoma Nursing and Rehabilitation
Center 1586 150 0 0 0 0 0 0 0 150
7/10/95 bank 17 beds. 11/1/98 bank 30 beds;
4/13/00 CHOW lost 47 beds. 7/11/01-3 beds
banked, total bed banking. 03/01/05, CHOW,
loss of 3 BB. 02/2013 name change [formerly
Regency at Tacoma Rehab Center]. 1/1/19
CHOW no name change.
The Oaks at Lakewood 1568 80 0 0 0 0 0 0 0 80
7/1/98 oper chg. Formerly Lakewood
Healthcare Center. 12/20/17 CHOW.
Formerly Kindred Transitional Care and
Rehabilitation-Lakewood
University Place Rehabilitation Center 1553 120 0 0 0 0 0 0 0 12010/1/17 CHOW; formerly University Place
Care Center
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR PIERCE 2,287 45 0 0 0 0 63 0 2,350
printed 1/7/2020...12:11 PM 19 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Life Care Center of The San Juan Islands CLOSED 0 0 0 0 0 0 85 0 85
7/1/95 bank 5 beds; 6/1/97 convert 5 beds;
9/1/97 CHOW-Cascade Medical Investors;
1/1/98 bank 20 beds; 10/30/98 banked 5
beds; 8/23/00 approved to convert 25 beds
back to SN use. 9/1/00 banked 25 beds.
10/01/01-5 beds banked. 12/10/02-Convert 5
beds.5/4/03-4 BB Converted. Extend 20 beds
to 01/01/06. Part of March 2007 Settlement -
Mod of 3 beds May 2007 07-38 - Conv 21
beds BB08-22. Formerly Islands
Convalescent Center; formerly Life Care
Center of San Juan. 11/01/25
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR SAN JUAN 0 0 0 0 0 0 85 0 85
Life Care Center of Mount Vernon 1393 121 0 0 0 0 0 0 0 121
12/1/95 change owner, purchased by Mount
Vernon Medical Investors Limited
Partnership; Formerly Mount Vernon Care
Center; 5/1/96 bank 16 beds; 5/1/00 extend
16 beds (letter sent 2/29/00); 8/23/00
approved to convert 16 beds back to SN use.
9/1/00 banked 22 beds. Name chg - formerly
Mt. Vernon Care Center. Extend 22 beds,
expire 09/01/08-no further extension. Part of
March 2007 Settlement - Conv 08-25 of 22
beds
Life Care Center of Skagit Valley 1388 150 0 0 0 0 0 0 0 150
1/96 change owner; 11/12/98 banked 8 beds;
formerly Skagit Valley Convalescent Center,
Inc. 8/23/00 approved to convert 8 beds back
to SN use. 9/1/01 banked 8 beds. 11/1/2001
banked 12 beds Alt Use. 08/01/02-10 beds .
banked. Extend 11 beds banked 09/01/04, 26
months remaining to 11/01/2006. 12 beds
banked 11/01/01 forfeited, untimely request,
18 beds remaining. Part of March 2007
Settlement BB08-20 conv 8 beds - BB09-28
Conv 12 beds. 4/2010 converted remaing 10
banked beds
Mira Vista Care Center 1524 94 0 0 0 0 0 0 0 94
RA #027, add 30 beds from Mira Vista at
United. 7/1/15 CHOW but no name change.
Prestige Care and Rehabilitation-
Burlington 1451 49 0 0 0 0 0 0 0 49
4/7/98 name chg-formerly Burton Care Ctr.
6/1/99 name chg-formerly Sunrise Care &
Rehab for Burlington. 12/1/99 CHOW,
purchased by Eagle Healthcare & changed
name back to Burton Care Center. CHOW
10/01/12 formerly Burton Care Center
San Juan Rehabilitation and Care Center 1546 0 0 0 0 0 0 0 26 0
4/7/98 name chg-formerly San Juan Care Ctr.
6/1/99 name chg-formerly Sunrise Care &
Rehab for Anacortes. 12/1/99 CHOW now
Eagle Healthcare (owning entity) - RA#052
Expired. 07/01/17 CHOW w/ no name
change. 08/22/17 FACILITY CLOSED.
Banked 26 of 52 beds under FFC. 08/22/25
printed 1/7/2020...12:11 PM 20 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Soundview Rehabilitation and Health
Care Center 1590 44 0 0 0 0 0 0 0 44
7/1/95 bank 42 beds; 5/21/98 RA #017 issued
for the remodel of Anacortes Convalescent
Center; 6/1/98 forfeit 21 licensed beds;
7/15/98 forfeit 12 licensed beds; 10/1/98
name chg-formerly Anacortes Conv Ctr;
7/1/99 forfeit 42 beds. 01/01/05-Name
Change Only: was Alliance Living Community
of Anacortes. 12/03/19 CHOW & name
change; formerly Fidalgo Care Center.
United General Hospital N/A 0 0 5 0 0 0 0 0 0
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR SKAGIT 458 0 5 0 0 0 0 26 458
Aldercrest Health and Rehabilitation
Center 1557 128 0 0 0 0 0 0 0 128
2/95 name changed from Washington
Healthcare Center-Aldercrest; 7/1/96 banked
32 beds; 8/1/99 banked 12 beds. 7/1/00
forfeit 32 beds (letter sent 6/15/00).Extend 12
beds banked on 8/1/99 to 8/1/07(no
extension).8/1/03 extended 12 BB to 8/1/07.
05/18/05 8 beds converted, 4 remain banked -
modified banked beds 3-22-06 - Converted 4
beds 07-44. 7/1/15 CHOW. 12/01/17 CHOW
Arlington Health and Rehabilitation 1334 76 0 0 0 0 0 0 0 76
5/1/96 chg owner. 04/01/14 relinquished 20
beds. 4/1/14 name change-formerly Regency
Care Center at Arlington.
Bethany at Pacific 1290 111 0 0 0 0 0 0 0 111
15 beds banked 11/05/93; CN #1089A appvd
31 beds for TCU (Bethany Transitional Care);
vol. gave up 5 beds; max. beds for NH is 101.
Name chg, was Bethany on Broadway.
6/2/00 CN #1207 issued to add 10 beds for a
total of 111 beds. Project complete 6/27/00
Bethany at Silver Lake 1049 120 0 0 0 0 0 0 0 120
Bothell Health Care 1439 99 0 0 0 0 0 0 0 99Formerly Life Care Center of Bothell, CHOW
8/2010
Delta Rehabilitation Center 545 125 0 0 0 0 0 0 0 125 7/13/07-voluntarily relinquished 12 beds.
Everett Center 1505 100 0 0 0 0 0 0 0 100
4/7/98 name chg-formerly Everett Rehab Med
Ctr. 6/1/99 name chg-formerly Sunrise Care &
Rehab for Everett. 7/1/00 name chg-formerly
Sunbridge Care & Rehab for Everett.
03/01/14 name change-formerly Everett Care
and Rehabilitation Center. 01/23/15 CHOW
Everett Transitional Care Services 1245 0 0 0 0 0 0 31 0 31
CN #1089A appvd 31 beds for TCU (Bethany
Transitional Care); max. beds for TCU is 50;
4/1/98 Bethany of NW and Prov. Hosp form
50-50 partnership; 6/1/98 name/oper chg-
formerly Bethany TCU. 03/25/19 FFC bed
banking for 31 beds. 03/14/27
Josephine Caring Community 143 160 0 0 0 0 0 0 0 16001/01/18 name change. Formerly Josephine
Sunset Home.
printed 1/7/2020...12:11 PM 21 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Lynnwood Post Acute Rehabilitation
Center 1478 67 0 0 0 0 0 0 0 67
2/1/00 banked 14 beds. 02/02/04, 14 beds
forfeited.02/01/05-Receivership, new licensee
Symmetry Long Term Care Group, LLC.
CHOW 5/1/06 from Lynnwood Manor Health
Care New Licensee: Lynnwood Health
Services. BB10-01 banking of 28 beds by
new owners - relinquished 15 of 28 beds on
06/01/10 [13 beds remain banked]. Name
change 12/2010. 06/2011 request to convert
13 banked beds, but failed to proceed with
conversion of 13 beds. 13 Beds remain
banked until 07/01/13. 07/15/13 - failed to
request to unbank 13 beds-13 banked beds
are relinquished. Zero beds remain banked.
09/03/14 CHOW for licensing. 06/01/17 name
change-formerly Emerald Hills Rehabilitation
and Skilled Nursing.
Manor Care Health Services (Lynnwood) 1593 113 0 0 0 0 0 0 0 113
9/3/96 name chg (formerly Manor Care Nsg &
Rehab Ctr) CHOW 12-21-07; 08/05/18
CHOW. 01/01/20 CHOW
Marysville Care Center 1534 97 0 0 0 0 0 0 0 976/1/96 Life Care Centers purchased as limited
partnership. 02/01/16 CHOW
Mountain View Rehabilitation and Care
Center 1463 82 0 0 0 0 0 0 0 82
11/94 formerly Madeleine Villa Conv. Ctr;
12/31/96 bank 16 beds/10/21/98 banked 4
beds. 8/23/00 extend 16 beds to 12/31/04.
Lost 4 beds banked on 10/21/98, 16 remain
banked. 10/24/04 convert 10 beds, bank 10 -
other.07/07/05 loss of 2 beds, relinquished
4=10 remain banked. Ext of 10 beds BB-09-
03- Mod 09-18 to rectify count and use in
room 28 - Banked 6 more beds for remainder
of ext period 5/2010. 10/25/12 lost 16 beds
banked under AU. 12/01/13 CHOW & new
name [formerly Madeleine Villa Care Center]
Prestige Care and Rehabilitation of
Edmonds [This is the FFC closed
facility w/ 9 FFC beds banked
remaining] CLOSED 0 0 0 0 0 0 9 0 9
7/1/98 oper chg. 3/1/02-5 beds banked.
02/12/04-4 beds banked. Banking extended
to 2010. Subsequent sale of facility in 2008
led to acknowledged loss of 9 banked beds.
05/08/13 FFB bed banking for 89 beds
expires 5/8/2021. 06/23/14 CN #1529 issued
for 80 of the 89 beds. 9 beds remain banked
under FFC. 05/08/21
Prestige Post-Acute and Rehab Center-
Edmonds 1528 80 0 0 0 0 0 0 0 80
CN #1529 issued on 06/23/14 approving the
estabilshment of an 80-bed nusring home
using 80 of the 89 FFC beds banked at
Prestige Care and Rehabilitation of Edmonds.
12/1/15 License issued. M/M facility
Providence Hospital N/A 12 0 0 0 0 0 0 0 12merge w/Bethany trans care - Everett
transitional care services 4112454
Regency Care Center at Monroe 1425 92 0 0 0 0 0 0 0 92 5/1/96 chg owner
Snohomish Health and Rehabilitation 1474 91 0 0 0 0 0 0 0 91
01/01/05 New Licensee: Merry Haven Care
Center, LLC. 09/01/14 CHOW formerly Merry
Haven Care Center
Sunrise View Convalescent Center 1166 59 0 0 0 0 0 0 0 59
7/1/95 change ownership; 1/9/98 bank 5
beds. 5 BB extended, expire 1/9/06 - 5 beds
lost 2/2007 with expiration
printed 1/7/2020...12:11 PM 22 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
View Ridge Care Center 1550 70 0 0 0 0 0 0 0 70
6/01/94 changed name; 4/16/96 RA#008
complete 2/98; 6/22/00 CN #1209 issued to
add 10 beds from Mt. Si Transitional Health
Center. At project completion, Forest View =
70 & Mt. Si = 76 licensed & 12 banked.
2/28/01 project authorized by CN #1209
complete. 2016 name change-formerly Forest
View Transitional Health Center. 08/01/17
CHOW & name change; formerly Regency
Everett Rehabilitation and Nursing Center.
Warm Beach Health Care Center 645 59 0 0 0 0 0 0 0 59
08/3/15 NH reliquished 15 beds [from 81 to
66] 10/17/16 NH relinquished 7 beds [from 66
to 59]
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR SNOHOMISH 1,741 0 0 0 0 0 40 0 1,781
Alderwood Manor 1102 85 0 0 0 0 0 0 0 85
Avalon Care Center at Northpointe 1358 119 0 0 0 0 0 0 0 119
CN #1111 - replacement facility of Lilac City &
Mansion House both of Spokane County.
12/17/03 CHOW aka Beverly Health & Rehab
at Northpointe.
Cheney Care Center 732 54 0 0 0 0 0 0 0 54
09/01/04 10 Bed banked, expire
09/01/08.04/01/05 conversion of 2 beds, 8
remain banked - BB08-31 ext of 8 BB.
Voluntary relq. Of 8 banked beds 11/2010
Franklin Hills Health and Rehabilitation
Center 1565 100 0 0 0 0 0 0 0 100
11/94 formerly Northcrest; 6/30/95 bank 7
beds; 7/1/96 banked 4 beds; 7/1/97 bank 5
beds; 10/24/97 bank 39 beds. 7/1/99 extend 7
beds banked on 7/1/95 to 7/1/03 (these 7
beds cannot be extended for another 4
years). 8/1/99 banked 4 beds. 7/1/00 forfeit 4
beds (letter sent 6/15/00); 3/29/01 extend 5
beds banked on 7/1/97 (these 5 beds cannot
be extended another 4 years). 7/13/01 extend
39 beds banked 10/24/97 (these 39 beds
cannot be extended another 4 years). Extend
4bb from 8/1/99, expire 8/1/07 (no extension).
Relinquish 7 beds banked on 7/1/03.
04/08/05 Loss of 5 BB from 7/1/97, no app
received, just a request to extend the period-
Jan responded. Relinquished 3 beds in room
15 effective 10/24/05.08/21/05 23 beds
converted. **Confirmation received on RA of
23 beds to Gardens on Univ. 6-23-06 - 21 of
121 beds relinquished with approval of CN07-
04. 7/1/15 CHOW. 12/01/17 CHOW.
Good Samaritan Society-Spokane Valley 1585 97 0 0 0 0 0 0 0 97
9/27/94 bank 31 beds - lost 7 beds-delic prior
to bnk appvl; '7/1/95 formerly Spokane Valley
Good Samaritan Center; 3/6/98 voluntarily
relinquish 30 banked beds used for assisted
living-see BB file; 11/1/99 relinquished 37
licensed beds & 1banked bed (total
38).11/01/01 banked 29 beds 9/21/2005. All
29 beds relinquished. Formerly Spokane
Valley Good Samaritan Village. 1/1/19 CHOW
no name change.
printed 1/7/2020...12:11 PM 23 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Manor Care Health Services (Spokane) 1596 125 0 0 0 0 0 0 0 125
9/3/96 name chg (formerly Manor Care Conv
& Rehab CHOW 12-21-2007; 08/05/18
CHOW. 01/01/20 CHOW
North Central Care Center 1571 99 0 0 0 0 0 0 0 99
7/1/94 change in operator; 01/01/13 relinquish
2 beds [from 101 to 99]. 1/11/18 CHOW &
name change-formerly North Central Care
and Rehabilitation
Providence St. Joseph Care Center 1417 113 0 0 0 49 0 0 0 162
5/1/94 name change; 10/1/96 bank 15 beds;
per CHOW 1/1/97combine operations w/St.
Joseph Care Center (formerly St. Brendan)-
same owner/licensee; 10/1/00 4 year
extension on 15 beds (letter sent 6/21/00);
loss of 15 beds - 5/4/01 banked 17 beds - 1-
29-07 approved to unbank 17 beds in lieu of
expansion to be done by Jan 30, 2008.
06/08/16 RA #087 issued for renovation.
05/11/18 AU bed banking 05/11/22
Regency at Northpointe 1432 120 0 0 0 0 0 0 0 120
7/10/95 bank 14 beds-lost 1 bed-delic.
w/DSHS prior to DOH appvl; 11/20/95
RA#003-facility to be replaced, will not bring
14 beds back on line (see 1995 NH
determinations file); formerly Regency Care
Center of Spokane; After completion of
RA#003 120 bed facility
Riverview Lutheran Retirement
Community of Spokane 544 75 0 0 0 0 0 0 0 75
01/01/16 name changed-formerly Riverview
Lutheran Care Center. 04/21/16 formerly
Riverview Care Center.
Rockwood at Hawthorne 1283 20 0 0 0 0 0 0 0 20
1/5/96 RA#002; name chg-formerly
Hawthorne Manor Retirement Residence; RA
#002 expired 1/5/98; 2/1/00 name chg-
formerly Hawthorne Retirement Community
Health Care.
Rockwood South Hill 457 0 45 0 0 0 0 0 0 0
Type A CCRC nursing home. 10/4/96 name
chg-formerly Rockwood Manor Infirmary -
5/09 formerly Rockwood Retirement Commun
Hlth Ctr
Royal Park Health and Rehabilitation 1471 164 0 0 0 0 0 0 0 1649/1/14 CHOW formerly Royal Park Care
Center
Sullivan Park Care Center 1345 125 0 0 0 0 0 0 0 1255/1/03 CHOW - Relinquished 2 beds in PT
remodel - DSHS reinstated 2 beds 8/08
Sunshine Health & Rehab 1050 84 0 0 0 0 0 0 0 848/15/96 RA #010. 01/18/19 name change-
formerly Sunshine Gardens
The Gardens on University 1566 124 0 0 0 0 0 0 0 124
5/23/94 bank 10 beds; 8/1/94 chg of
oper./name chg-formerly Unicrest Nsg &
Rehab Ctr; 3/1/95 name chg from The
Gardens; 6/30/95 bank 14 beds; 4/1/98
convert 2 beds. Extended 10 beds banked
5/23/94 to 5/23/02. Extended 12 beds banked
on 6/30/95 to 7/1/2003.Relinq 10 beds,
forfeited 12 beds.12/22/03-Reconsideration of
12 forfeited beds, relinquish 4 convert 8,
effective 01/01/04. **Confirmation received on
RA of 23 beds from Franklin Hills 6-23-06.
7/1/15 CHOW. 12/01/17 CHOW.
Touchmark on South Hill 1201 57 0 0 0 0 0 0 0 57CN#976;online 5/30/96 - CHOW in 6/2011
formerly Waterford on South Hill Rehab
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR SPOKANE 1,561 45 0 0 49 0 0 0 1,610
Buena Vista Healthcare 1502 40 0 0 0 0 0 0 0 406/11/98 oper chg. 2/1/15 CHOW-formerly
Buena Vista Inc
printed 1/7/2020...12:11 PM 24 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Mount Carmel Hospital N/A 5 0 4/25/02-5 swing beds
Prestige Care & Rehabilitation-Pinewood
Terrace 1457 92 0 0 0 0 0 0 0 92
6/30/95 bank 1 bed. 7/1/99 extension denied,
lost 1 bed. 7/22/99 CHOW to Beverly
Healthcare-California, Inc (no change in name
of facility). 12/15/99 CHOW, Licensee is now
Beverly Enterprises - Washington, Inc. 7/1/00
CHOW: licensee Eagle Healthcare, Inc.
11/28/12 CHOW & name change. [formerly
Pinewood Terrace Nursing Center]
Providence St. Joseph Hospital CLOSED 0 0 25 0 0 0 40 0 40 aka St. Joseph Hospital of Chewelah 08/13/27
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR STEVENS 132 0 30 0 0 0 40 0 172
ManorCare Health Services-Lacey 1595 120 0 0 0 0 0 0 0 120CN #1392 issued 2/18/09; license issued
5/9/12; 08/05/18 CHOW. 01/01/20 CHOW
Olympia Transitional Care and
Rehabilitation 1511 135 0 0 0 0 0 0 0 135
1/25/96 RA #005 to redistribute 20 beds to
Puget Sound Healthcare Center; after
redistribution completion, total licensed beds
to be 131; 7/1/96 banked 16 beds; 9/3/97
unbank 16 beds; 9/10/97 transfer 16 beds to
PS HC. 11/01/2001-21BB. 07/01/03-convert 6
BB. 07/01/04 convert 4 beds due to expire
on 11/01/05. Extend 11 beds to 11/01/09,
unable to extend again. Conv of 2 beds 1/09 -
BB09-29 Conv 4 beds. 7/1/15 CHOW;
formerly Evergreen Nursing and Rehabilitation
Center
Panorama City Convalescent and
Rehabilitation Center 507 155 0 0 0 0 0 0 0 155
Providence Mother Joseph Care Center 1067 152 0 0 0 0 0 0 0 152 8/95 formerly Mother Joseph Care Center
Puget Sound Healthcare Center 1561 108 0 0 0 0 0 0 0 108
1/25/96 RA #005 to receive 20 beds from
Evergreen Nsg & Rehab; after redist
complete, total licensed beds=120; 9/10/97
transf 16 beds from Evergreen; RA executed
for 16 beds instead of 20 as authorized; 4
beds remain lic at Evergreen; 12/10/99
banked 8 beds. 7/1/01-2 BB. Of the 8 beds
banked, only 2 remain, lost 6. 2 beds
extended to end 12/10/07-no further
extensions.07/01/04 2 BB converted, no bb
remaining. 12/01/17 CHOW.
Regency Olympia Rehabilitation and
Nursing Center 1423 28 0 0 0 0 0 0 0 28
9/10/99 RA #025 issued for renovation of
Olympia Manor. 12/9/16 name change-
formerly Olympia Manor
Roo-Lan Healthcare Center 729 96 0 0 0 0 0 0 0 96Voluntary relinqushment of 7 of the 103
licensed beds 7/1/11
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR THURSTON 794 0 0 0 0 0 0 0 794
printed 1/7/2020...12:11 PM 25 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Columbia View Care Center CLOSED 0 0 0 0 0 0 0 35 0
4/7/98 name chg-formerly Columbia View
Care Ctr. 6/1/99 name chg-formerly Sunrise
Care & Rehab for Cathlamet. 8/23/00 banked
3 beds. 9/24/02-convert 3 beds. 10/1/02
CHOW-name chg-formerly SunBridge Health
& Rehabilitation for Cathlamet.10/03/02 17
beds Banked. Extended banking to 2010.
Voluntary relinquishment of 17 beds
6/30/2010 - Voluntary relinquishment of 1
bed 7/2011. Ceased operation of 35 beds
8/1/2012.08/01/20
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR WAHKIAKUM 0 0 0 0 0 0 0 35 0
Park Manor Rehabilitation Center 1476 99 0 0 0 0 0 0 0 99
5/1/94 changed name; 8/1/95 bank 5 beds;
4/6/98 name chg-formerly Blue Mtn Med &
Rehab Ctr. CHOW forfeit 5 beds. 6/1/99
name chg-formerly Sunrise Care & Rehab for
Walla Walla Valley. CN 1326 issued
4/10/2006 to add 30 beds, expires 4/10/2008
unless extended. Bank of 10 beds BB10-04.
08/02/13 loss of 10 AU banked beds.
09/03/14 CHOW for licensing purposes only.
Regency at the Park 1433 106 0 0 0 0 0 0 0 106
11/23/93 banked 4 beds; 7/10/95 bank 11
beds. 3/26/98 RA #018 issued to remodel
Regency at Walla Walla; 7/10/99 extension
request expired forfeit 15 beds. 7/17/01 -
revised total to 86 - per Carole Campbell, only
86 beds licensed at new facility opening on
02/09/99. CN 1322 issued 12/20/2005 to add
20 beds. CN expires 12/20/2007 unless
extended.
Walla Walla General Hospital N/A 0 0 5 0 0 0 0 0 0 07/24/17 Hospital Closed
Washington Odd Fellows Home 351 117 0 0 0 0 0 0 0 117
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR WALLA WALLA 322 0 5 0 0 0 0 0 322
Alderwood Park Health and Rehabilitation 1473 102 0 0 0 0 0 0 0 1029/1/14 CHOW formerly Alderwood Park
Convalescent
Avamere Bellingham Health Care and
Rehabilitation 1460 84 0 0 0 0 0 0 0 84
6/26/95 bank 9 beds; 7/1/98 oper/owner chg;
9/17/98 forfeit 9 banked beds; 1/1/99 banked
14 beds.01/01/03 extended 14 beds per
reconsideration.3/1/02 9 beds banked -
Extended 9 banked beds 3-22-06 - 10-1-06
converted 3 beds back into service and
delicensed 11 - BB08-26 banked 7 additional
beds for remaining 22 months. Voluntary
relinquishment of 16 beds 8/2010. CHOW
04/01/13
Christian Health Care Center 1322 142 0 0 0 0 0 0 0 142
3/5/96 RA#006 (replace with 127 bed facility);
8/1/96 bank 17 beds; lost 4 beds-delic.
w/DSHS prior to bed bank appvl.; RA #006
VOID. 6/29/99 RA #023 issued for the
replacement of Christian Health Care Center
with an 146 bed facility. 11/1/99 banked 7
beds, relinquished 4 beds, total license
capacity is 118. 8/1/00 convert 2 beds &
extend 15 beds (letter sent 6/21/00). 4/9/01
RA#023 completed and NH is licensed.
printed 1/7/2020...12:11 PM 26 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Good Samaritan Society - Stafholt 1587 57 0 0 0 0 0 0 0 57
6/1/99 banked 8 beds.6/1/03-extended 8 BB -
loss of 8 beds w/ 8yr BB expiration. 01/01/19
CHOW
Highland Health and Rehabilitation 1472 44 0 0 0 0 0 0 0 44 9/1/14 CHOW formerly Highland Care Center
Mt Baker Care Center 1333 70 0 0 0 0 0 0 0 70 5/1/96 chg owner;
North Cascades Health and Rehabilitation
Center 1348 122 0 0 0 0 0 0 0 122
7/1/95 bank 5 beds; 8/31/96 banked 8 beds;
4/7/98 name chg-formerly Bayside Health &
Rehab; RA #019 issued 7/9/98; RA #019R
issued 8/4/98. 8/31/99 extend 5 beds banked
on 8/31/95 to 8/31/03. 6/1/99 name chg-
formerly Sunrise Care & Rehab - Bayside.
10/1/99 unbanked 13 beds; 6/26/00 name
chg-formerly Sunbridge Care & Rehab-
Bayside. 08/01/03 CHOW-Cordata
Healthcare. CHOW 02/01/04, new Licensee
Evergreen Kitsap, LLC. aka Evergreen North
Cascades
Shuksan Healthcare Center 1591 52 0 0 0 0 0 0 0 52
8/1/94 facility purchased by Bellingham Assn.
& operated by Sunrise Health; 7/1/95 bank 3
beds; 1/96 formerly Shuksan Convalescent
Center; 7/1/96 banked 6 beds; 4/7/98 name
chg-formerly Shuksan Rehab & Living. 6/1/99
name chg-formerly Sunrise Care & Rehab.
12/1/99 purchased by Eagle Healthcare.
4/13/00 CHOW-lost 9 banked beds. 06/30/01
bank 14 beds. 06/30/05 extend 14 beds, final
expiration on 6/30/09. RA#053 Expired - Conv
14 beds 6/09. 05/12/17 CHOW; no name
change. 12/3/19 CHOW & no name change
St. Francis of Bellingham 1398 120 0 0 0 0 0 0 0 120CHOW 10-1-06 - new licensee St Francis
Operations
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR WHATCOM 793 0 0 0 0 0 0 0 793
Avalon Care Center-Pullman 1361 48 0 0 0 0 0 0 0 48
4/1/94 name change; 6/29/95 bank 7 beds;
lost 2 beds-chgd use of rm 3 during banking.
7/1/99 extension request denied, loss of 5
banked beds. 12/15/99 CHOW, Licensee is
now Beverly Enterprises - Washington,
Inc.12/01/03-CHOW-name change from
Palouse Hills Conv Center. 02/23/17 RA #089
issued for replacement of facility to a new site
in Pullman.
Pullman Regional Hospital 5 2/20/90 approval for 5 swing beds
Tekoa Care Center CLOSED 0 0 0 0 0 0 32 0 32
9/30/95 bank 6 beds; 7/20/99 extend bb for 6
beds to 10/1/03. All 6 banked beds forfeited.
09/01/15 CHOW no name change
10/17/18 converting to assisted living facility,
banking 32 beds, relinquishing 33 beds, per
Josh Wester. 10/18/26
Whitman Community Hospital 0 0 5 0 0 0 0 0 0
Whitman Health and Rehabilitation
Center 1240 55 0 0 0 0 0 0 0 55
6/26/95 bank 19 beds; 1/1/98 unbank 19
beds; 4/1/98 name/owner chg-Evergreen WA
HC LLC dba Whitman Hlth & Rehab Ctr;
7/1/98 bank 15 beds. 15 beds forfeited,
request not timely.09/01/03-7 beds banked,
exp 9/1/07. Loss of 7 beds 4yr BB expiration.
Voluntary relinquishment of 14 beds 12/2010
printed 1/7/2020...12:11 PM 27 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR WHITMAN 103 0 10 0 0 0 32 0 135
Crescent Health Care. Inc. 1391 85 0 0 0 0 0 0 0 85
5/1/98 banked 20 beds. 11/7/00 approved 11
beds to be banked effective 11/7/00.Extend
20 BB to 05/01/06. 11 beds banked 11/7/00
expired-no request, 20 BB remaining. 1-29-07
Loss of remaining 20 beds with expiration of
bb period - voluntarily relinquished 8 beds
7/09
Emerald Care 1366 82 0 0 0 0 0 0 0 82
7/1/95 banked 3 beds; 9/1/96 banked 6 beds
71/99 extension request expired forfeit 3
beds. 6/15/00 forfeit 3 beds; converted 3
beds (letter sent 6/15/00). 01/01/04 CHOW,
AKA Emerald Circle Convalescent Center
Garden Village 1437 101 0 0 0 0 0 0 0 101
11/1/96 owner chg: Central Care Inc (Rick
Chasteen Group); 6/1/98 owner chg-Integrity
(Rick Chasteen); 6/1/98 oper chg; Name
change from Central Convalescent 3/99.
8/30/99 RA #024 issued for renovation of
Memorial Hospital's Garden Village to be 104
beds at project completion. 12/15/00 facility in
CHOW process. Request to bank 9 beds
after CHOW completed. DOH approval sent
12/15/00. CHOW completed 2/1/01. Banked 9
beds 02/01/01.02/01/05 Extend bed banking
02/01/09 - Conv 09-06 of 9 beds. 01/01/16
relinquished 3 beds
Good Samaritan Health Care Center 1422 105 0 0 0 0 0 0 0 105
6/1/96 change owner; OJR, Inc. to operate &
lease. CHOW to Regency Pacific, Inc. eff.
4/1/2001. 07/01/01 bank 15 beds. 7/11/05-
untimely extension request, forfeiture of 15
beds, none banked.
Heritage Grove TBD 97 0 0 0 0 0 0 0 97
8/1/94 change of operator & name change
(formerly Chalet Healthcare); 8/1/95 bank 7
beds. 8/31/99 unbank 7 beds. 11/1/99 chng
of operator and name (formerly Heritage
Gardens Care Center). 2/1/01 banked 8 beds.
Extend 7of 8 beds banked-due to expire 02-
01-09.- 1 bed lost in room 5. Remaining 7
banked beds + 4 additional (11 total) beds
relinquished. 10/15/09 FFC bed banking of
97 beds. 08/10/15 CN #1557 issued to
Heriitage Grove for a 97 bed NH in Yakima.
Under Thurston County judicial review #17-
2-05158-3 10/15/17
Landmark Care and Rehabilitation 1372 93 0 0 0 0 0 0 0 93
8/9/96 RA #009; 8/9/98 6 month ext. to RA
#009; 7/1/98 bank 8 beds. 7/1/99 unbank 8
beds. 2/1/00 replacement facility and name
chg (formerly Yakima Convalescent Ctr).
CHOW to Aegis Partners, Inc. eff.
3/1/01.01/01/05, New Licensee: Hygate
Properties Inc.
Prestige Care and Rehabilitation-Parkside 1458 88 0 0 0 0 0 0 0 88
9/1/00 CHOW. 11/28/12 CHOW & name
change [formerly Parkside Nursing Care
Center]
printed 1/7/2020...12:11 PM 28 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Prestige Care and Rehabilitation-
Grandview CLOSED 0 0 0 0 0 0 46 0 46
6/30/95 bank 20 beds; convert date extend to
6/30/01 per Order - addtl 2 yr extend to
6/30/03. Forfeited 20 banked beds. RA #073
approved replacement of 14 beds from
Grandview to Hillcrest Manor. Grandview
total beds is now 46. CHOW 10/01/12
formerly Grandview Health Care Center.
Facility closed 10/24/14; FFC bed banking 10/24/22
Prestige Care and Rehabilitation-
Sunnyside 1454 80 0 0 0 0 0 0 0 80
6/30/95 banked 4 beds; convert date extend
to 6/30/01 per Order - addtl 2 yr extend to
6/30/03.14 BB 06/30/01. Forfeited t beds
banked 6/30/95.01/28/05 relinquished 7 BB +
4 additional.06/30/05 extended 14 BB expire
06/03/09=no extensions. Loss of 14 beds in
exp of BB extension 8/09. Formerly Hillcrest
Manor. RA #073 approved renovation &
addition of 14 beds from Grandview, for a
total of 80 beds at Hillcrest Manor. CHOW
10/01/12 formerly Eagle Rehab at Sunnyside
Selah Care and Rehabilitation CLOSED 0 0 0 0 0 0 39 0 39
07/01/17 CHOW w/no name change
08/14/19 approved to bank 39 08/15/27
Summitview Healthcare Center 359 78 0 0 0 0 0 0 0 78
1/15/97 name chg-formerly Summitview
Manor. Banked 18 beds 1/1/99; 3/31/00
banked 35 beds. 5/1/01 banked 3
beds.1/1/03 Voluntary relinquished 6 beds.18
BB 1/1/99 forfeited, not timely. 35 banked
beds forfeited. Loss of three banked beds,
none remaining.
8/2018 - approved reno.auth. for 78 beds
Toppenish Nursing and Rehabilitation
Center 1354 75 0 0 0 0 0 0 0 75
4/1/97 bank 10 beds; 4/6/98 name chg-
formerly Valley Med & Rehab Ctr. 6/1/99
name chg-formerly Sunrise Care & Rehab for
Yakima Valley. Reminder letter to act on 10
banked beds mailed 10/13/00. Extension
granted for 10 beds to 4/1/05.10/01/03-
CHOW- Sunbridge Care & Rehab for Yakima
Valley. 08/25/04 Loss of 10 banked beds due
to CHOW. New Owners Banked 15 07-47 -
Voluntary Relinqishment of 15 beds 6/2010
Willow Springs Care and Rehabilitation 1392 75 0 0 0 0 0 0 0 75
7/1/00 banked 14 beds. 10/27 00 banked 10
beds. 4/9/01 convert 24 beds back to skilled
use. 5/1/01 banked 9 beds.9 beds banked on
05/01/01 lost, none remaining. Old Name:
Renaissance Care Center
-------- -------- -------- -------- -------- -------- -------- -------- --------
BED COUNT FOR YAKIMA 959 0 0 0 0 0 85 0 1,044
STATEWIDE TOTALS 19,162 196 251 45 49 15 1,222 191 20,493
State Owned/Operated - Not Counted:
Fircrest School Pat A, Pat B, Pat N 4088464 King CountyFrances Haddon Morgan Center CLOSED Kitsap CountyLakeland Village Nursing Facility 4088472 Spokane CountyLakeland Village 4012001 Spokane County
printed 1/7/2020...12:11 PM 29 of 30
DOH 260-023 January 2020
Washington State Certificate of Need
Nursing Home Bed Supply Log
SWING
BEDS
CN
APPVD
+
RA
REDSTRB
APPVD
+
ALT
USE
SECT 8
+NURSING HOME BED INVENTORY - BY COUNTY
NH
LICENSE
NUMBER
LICENSED
BEDS
LICENSED
TYPE A
CCRC
ADJUSTED
TOTAL-
COUNTED
BEDS
COMMENTS/NOTESUPCOMING
BB XPN
DATE
NON-
LICENSEE
CLOSURE
SECT 13 B
LICENSEE
CLOSURE
SECT 13 B
+
Spokane Veteran's Home 4000121 Spokane CountyRainier School Pat A 4012000 Pierce CountyRainier School Pat C 4014000 Pierce CountyRainier School Pat E 4016000 Pierce CountyWashington Soldiers Home 4000014 Pierce CountyWashington Veterans Home - Retsil 4000006 Kitsap CountyYakima Valley School 1045004
Tribal Homes - Not Counted 40 0 0 0 0 8 0 07/20/99 bank 12 beds. 10/9/02 convert 4
beds. 07/20/04
Colville Tribal Convalescent Center 4176400 Okanogan County
printed 1/7/2020...12:11 PM 30 of 30
DOH 260-023 January 2020