Hearth Record

Avamere Transitional Care of Puget Sound

A nursing home in Tacoma, Washington 98465

630 South Pearl Street, Tacoma, Washington 98465. (253) 671-7300.

CMS’s own record, on Care Compare

Watch and the shortlist are kept with a free account, on every device. Your watch list. CMS’s own record is on Care Compare.

The short answer

Record last released by CMS on Oct 28, 2026.

The last 24 months 26 citations in 6 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). Every month

Each figure’s source sits beside it, in its section below.

What these words mean7
Star ratings
CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
Inspection (survey)
A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
Deficiency, citation, violation
What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
Scope and severity (A to L)
CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
Nurse staffing hours
The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
Fines and payment denials
A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
Capacity
The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.

What did inspectors find?

14 health citations at the latest inspection cycle

The Washington average is 15.7.

Last standard inspection Nov 25, 2025.

Most serious in three years: actual harm (G), at a complaint inspection on Mar 19, 2026

Source:

CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

When those citations happened

26 citations in 6 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.

26 citations by month over the last 3 years. Each cell is one month.
JanFebMarAprMayJunJulAugSepOctNovDec
2023 Dec
2024 JanFebMarAprMayJunJulAugSepOctNovDec
2025 JanFebMarAprMayJunJulAugSepOctNovDec
2026 JanFebMarAprMayJunJulAugSepOctNov

Hover or focus a month to read it.

No visit on record Visited, nothing cited A stronger orange is more serious, on its source’s own levels, read onto four bands: from the least serious it publishes to the most
Source:

Hearth Record drew this from the dates and levels in the source’s own records.

All 26 citations in the last three years

Grouped by inspection, newest first. Each carries , from A, the least serious, to L, the most. 5 came from complaint inspections.

Source:

CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Aug 12, 2026: complaint inspection1 citation

  • Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Rule F0686. D: no actual harm, potential for more than minimal harm. From a complaint.

Mar 19, 2026: complaint inspection2 citations

  • Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Rule F0686. G: actual harm. From a complaint. Correction date, as CMS recorded it: Apr 13, 2026.

  • Ensure each resident receives an accurate assessment.

    Rule F0641. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 13, 2026.

Nov 25, 2025: standard inspection11 citations

  • Honor the resident’s right to and the facility must promote and facilitate resident self-determination through support of resident choice.

    Rule F0561. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Rule F0657. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Provide care and assistance to perform activities of daily living for any resident who is unable.

    Rule F0677. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Provide safe and appropriate respiratory care for a resident when needed.

    Rule F0695. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Rule F0725. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Rule F0756. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Ensure each resident’s drug regimen must be free from unnecessary drugs.

    Rule F0757. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • 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.

    Rule F0761. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • Provide and implement an infection prevention and control program.

    Rule F0880. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

  • 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.

    Rule F0803. C: no actual harm, potential for minimal harm. Correction date, as CMS recorded it: Oct 30, 2025.

Sep 15, 2025: complaint inspection1 citation

  • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Rule F0609. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 1, 2025.

Mar 13, 2025: complaint inspection1 citation

  • Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.

    Rule F0808. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Mar 7, 2025.

Jul 31, 2024: standard inspection10 citations

  • Respond appropriately to all alleged violations.

    Rule F0610. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Ensure each resident receives an accurate assessment.

    Rule F0641. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

    Rule F0656. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Rule F0689. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Ensure each resident’s drug regimen must be free from unnecessary drugs.

    Rule F0757. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • 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.

    Rule F0761. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Provide and implement an infection prevention and control program.

    Rule F0880. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

    Rule F0882. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

  • Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member’s vaccination status.

    Rule F0887. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 11, 2024.

Is it certified, and in good standing?

  • Certified for Medicare and Medicaid since Mar 27, 2017.
  • Not on CMS’s special focus list.
  • No abuse icon from CMS.
  • No change of ownership in the last 12 months.
  • CMS lists its ownership as for profit, limited liability company.
  • 60 certified beds.
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Has it been fined or penalized?

  • 1 fine in the last three years, $23,319 in all.
  • No Medicare payment denials in the last three years.
  • 5 citations in the last three years came from complaint inspections.
Source:

CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Fines and payment denials, newest first
DateKindAmount
Mar 19, 2026Fine$23,319

Who does the caring?

5.17 nurse hours per resident per day

The Washington average is 4.42.

CMS publishes staffing about four months after the fact.

Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

Staffing measures
MeasureThis homeWashington average
Nurse hours per resident per day5.174.42
Of which registered nurses1.880.99
At weekends4.403.82
Nursing staff turnover31.9%43.9%
Registered nurse turnover37.5%43.8%
Administrators who left0Not given

Who owns it?

  • Ariso LLC owns 100% directly since Jan 6, 2006.
  • Avamere Health Services LLC and Avamere Skilled Advisors LLC and Midcap Finco LLC run it.
  • 44 owners or officers are people: Karl Rickard Miller (owns 5% or more through other companies, 100%); Michelle Funderberg (on the governing body (managing control)); Michelle Funderberg (additional disclosable party (controls, leases property to, or provides services to the home)); Katherine Fowler (runs it (operational or managerial control)); Katherine Fowler (additional disclosable party (controls, leases property to, or provides services to the home)); Bradley J Schmitz (runs it (operational or managerial control)); Bradley J Schmitz (additional disclosable party (controls, leases property to, or provides services to the home)); Andrew Simpson (runs it (operational or managerial control)); Glen Robert Cavallo (on the governing body (managing control)); Sherrie Wagner (additional disclosable party (controls, leases property to, or provides services to the home)); Carolyn Staples (on the governing body (managing control)); Carolyn Staples (additional disclosable party (controls, leases property to, or provides services to the home)); Cindy Throne (additional disclosable party (controls, leases property to, or provides services to the home)); Tonya Fisher (runs it (operational or managerial control)); Ike Okoli (runs it (operational or managerial control)); Ike Okoli (additional disclosable party (controls, leases property to, or provides services to the home)); Catherine Johnson (runs it (operational or managerial control)); Catherine Johnson (additional disclosable party (controls, leases property to, or provides services to the home)); Todd Inskeep (on the governing body (managing control)); Todd Inskeep (additional disclosable party (controls, leases property to, or provides services to the home)); Roberto Garcia (runs it (operational or managerial control)); Roberto Garcia (on the governing body (managing control)); Roberto Garcia (additional disclosable party (controls, leases property to, or provides services to the home)); Colby Strunk (on the governing body (managing control)); Colby Strunk (additional disclosable party (controls, leases property to, or provides services to the home)); Glen Roderick (runs it (operational or managerial control)); Glen Roderick (additional disclosable party (controls, leases property to, or provides services to the home)); Loriel Fanunal (runs it (operational or managerial control)); Loriel Fanunal (additional disclosable party (controls, leases property to, or provides services to the home)); Kim Games (additional disclosable party (controls, leases property to, or provides services to the home)); Julie Davis (additional disclosable party (controls, leases property to, or provides services to the home)); Mary Kofstad (runs it (operational or managerial control)); Mary Kofstad (on the governing body (managing control)); Mary Kofstad (additional disclosable party (controls, leases property to, or provides services to the home)); Yolanda Presley (runs it (operational or managerial control)); Yolanda Presley (additional disclosable party (controls, leases property to, or provides services to the home)); Cody Feakin (runs it (operational or managerial control)); Cody Feakin (on the governing body (managing control)); Cody Feakin (additional disclosable party (controls, leases property to, or provides services to the home)); Misty Dawn Reid (runs it (operational or managerial control)); Misty Dawn Reid (on the governing body (managing control)); Misty Dawn Reid (additional disclosable party (controls, leases property to, or provides services to the home)); Carrie Vanderzanden (on the governing body (managing control)); Carrie Vanderzanden (additional disclosable party (controls, leases property to, or provides services to the home)).
  • Part of Avamere (27 homes in CMS’s data).
  • No private-equity firm among the owners CMS lists.
  • A real-estate investment trust is among the owners CMS lists.
Source:

CMS, All Owners. Checked Nov 5, 2026. Updated monthly.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Organisations CMS lists
OrganisationRoleShareSince
Ari Operations LLCOwns 5% or more through other companies100%Jan 6, 2006
Midcap Finco LLCHolds 5% or more security interest100%Jan 22, 2010
Ariso LLCOwns 5% or more directly100%Jan 6, 2006
Karl Rickard Miller Jr Revocable TrustOwns 5% or more through other companies100%Jul 11, 2011
Avamere Health Services LLCRuns it (operational or managerial control)100%Jan 1, 2005
Avamere Group LLCOwns 5% or more through other companies100%Jan 1, 2006
Avamere Skilled Advisors LLCRuns it (operational or managerial control)Jan 1, 2005
Avamere Skilled Advisors LLCAdditional disclosable party (controls, leases property to, or provides services to the home)Jul 7, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 17, 2017
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jul 7, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jul 7, 2025
Midcap Finco LLCRuns it (operational or managerial control)Jan 22, 2010
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 7, 2015
Avamere Health Services LLCAdditional disclosable party (controls, leases property to, or provides services to the home)Mar 17, 2026
Snapmedtech,inc.Additional disclosable party (controls, leases property to, or provides services to the home)Sep 8, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jul 7, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jul 7, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jul 7, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 17, 2017
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Apr 8, 2026
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 17, 2017

How do residents fare?

  • CMS rates its quality measures 5 of 5 (Washington average 4.1).
Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

CMS’s star ratings, from 1 to 5
MeasureRating
Overall rating5 of 5
Health inspections3 of 5
Staffing5 of 5
Quality measures5 of 5

How does it compare nearby?

  • Among the 12 nearest homes, within 6.8 miles, this one had the 10th most health citations at the latest inspection cycle (14; the middle value was 23).
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

The 12 nearest, by straight-line distance
PlaceMiles awayCitations, latest cycle
Avamere Transitional Care of Puget Sound This nursing home14
Eliseo0.523
Park Rose Care Center1.65
Cottesmore of Life Care2.88
Orchard Park Health Care & Rehab Center3.059
Agility Health and Rehabilitation3.416
Birch Creek Post Acute & Rehabilitation3.527
Gig Harbor Health and Rehabilitation4.239
Avamere at Pacific Ridge4.723
Alaska Gardens Health and Rehabilitation4.717
Avalon Healthcare - Tacoma6.223
Heartwood Extended Healthcare6.831

What the record doesn’t say

  • Complaints that didn’t lead to a citation aren’t published.
  • Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
  • CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
  • Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.

Sources

  • Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).

    Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.

Source:

This copy of the record was made on Nov 5, 2026.

From the home

The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.

Replies

None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.

Paid listing

None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.

How to read a record

Four things every record does, shown on an example record made up for this guide.

An example record, made up for this guide

An example nursing home

Made up for this guide: no real place is shown

Not fully inspected in over two years (CMS flag)

11 health citations at the latest inspection cycle

The state average is 14.3.

Source:

CMS, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

From the homeNone yet. Replies and paid listings aren’t open, and when they open they will sit here, below the record.

1 of 4

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