Nursing Care Index

Avamere Transitional Care Of Puget Sound

Tacoma, Pierce County, Washington · CCN 505529 · For-profit (LLC) · part of Avamere (27 facilities, chain average 3 stars)

CMS rates Avamere Transitional Care Of Puget Sound 4 of 5 overall as of August 2026. 60 certified beds, 54 residents a day on average. 45 citations on record from the current inspection cycles, 1 involving actual harm; 1 fine totalling $23,319.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★★★☆ 4 of 5
Health inspections★★★☆☆ 3 of 5
Staffing★★★★★ 5 of 5
Quality measures★★★★☆ 4 of 5
Quality: long-stay / short-stay4 / 5 of 5

Staffing

Total nurse staffing5.1654 hours per resident per day
Registered nurses1.87108 hours per resident per day
Weekend total4.35129 hours per resident per day
Nursing staff turnover34.3% (registered nurses 38.1%)
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-03-19
complaint survey
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2026-04-13
2026-03-19
complaint survey
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-13
2025-11-25 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.
Pharmacy Service Deficiencies · tag F0761
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-10-30
2025-11-25 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-30
2025-11-25 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-30
2025-11-25 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Resident Rights Deficiencies · tag F0561
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · tag F0757
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-30
2025-11-25 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.
Nutrition and Dietary Deficiencies · tag F0803
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2025-10-30
2025-09-15
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-01
2025-03-13
complaint survey
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.
Nutrition and Dietary Deficiencies · tag F0808
D No actual harm, with potential for more than minimal harm; isolated Past Non-Compliance
2025-03-07
2024-07-31 Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · tag F0757
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 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.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Infection Control Deficiencies · tag F0882
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2024-07-31 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.
Infection Control Deficiencies · tag F0887
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-11
2023-08-18 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Rights Deficiencies · tag F0625
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18
complaint survey
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18 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.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18 Implement a program that monitors antibiotic use.
Infection Control Deficiencies · tag F0881
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-28
2023-08-18
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies · tag F0655
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care Deficiencies · tag F0693
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Quality of Life and Care Deficiencies · tag F0694
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · tag F0757
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28
2023-08-18 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service Deficiencies · tag F0758
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-09-28

Fines and payment denials

DatePenaltyAmount
2026-03-19Fine$23,319

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Midcap Finco LLC
Organization
5% or greater security interest2010-01-22
Avamere Health Services LLC
Organization
adp of the snf2026-03-17
Avamere Skilled Advisors LLC
Organization
adp of the snf2025-07-07
Snapmedtech,Inc.
Organization
adp of the snf2025-09-08
Avamere Health Services LLC
Organization
operational/managerial control2005-01-01
Avamere Skilled Advisors LLC
Organization
operational/managerial control2005-01-01
Midcap Finco LLC
Organization
operational/managerial control2010-01-22
Davis, Julie
Individual
adp of the snf2024-08-01
Fanunal, Loriel
Individual
adp of the snf2023-01-02
Feakin, Cody
Individual
adp of the snf2025-01-01
Fowler, Katherine
Individual
adp of the snf2025-02-28
Funderberg, Michelle
Individual
adp of the snf2024-12-31
Games, Kim
Individual
adp of the snf2024-08-15
Garcia, Roberto
Individual
adp of the snf2026-02-01
Inskeep, Todd
Individual
adp of the snf2022-01-21
Johnson, Catherine
Individual
adp of the snf2023-10-09
Kofstad, Mary
Individual
adp of the snf2024-02-13
Okoli, Ike
Individual
adp of the snf2026-03-19
Presley, Yolanda
Individual
adp of the snf2025-01-06
Reid, Misty
Individual
adp of the snf2025-01-02
Roderick, Glen
Individual
adp of the snf2024-02-01
Schmitz, Bradley
Individual
adp of the snf2023-09-01
Staples, Carolyn
Individual
adp of the snf2023-10-05
Strunk, Colby
Individual
adp of the snf2022-09-06
Throne, Cindy
Individual
adp of the snf2025-11-10
Vanderzanden, Carrie
Individual
adp of the snf2025-01-01
Wagner, Sherrie
Individual
adp of the snf2025-12-16
Kofstad, Mary
Individual
individual is an owner, partner or trustee of any adp of the snf2026-05-26
Cavallo, Glen
Individual
managing control - governing body2025-06-01
Feakin, Cody
Individual
managing control - governing body2025-06-01
Funderberg, Michelle
Individual
managing control - governing body2025-06-01
Garcia, Roberto
Individual
managing control - governing body2026-02-01
Inskeep, Todd
Individual
managing control - governing body2025-06-01
Kofstad, Mary
Individual
managing control - governing body2025-06-01
Reid, Misty
Individual
managing control - governing body2025-06-01
Staples, Carolyn
Individual
managing control - governing body2025-10-01
Strunk, Colby
Individual
managing control - governing body2025-06-01
Vanderzanden, Carrie
Individual
managing control - governing body2025-06-01
Fanunal, Loriel
Individual
operational/managerial control2023-01-02
Feakin, Cody
Individual
operational/managerial control2025-07-15
Fisher, Tonya
Individual
operational/managerial control2026-01-19
Fowler, Katherine
Individual
operational/managerial control2025-02-28
Garcia, Roberto
Individual
operational/managerial control2026-02-01
Johnson, Catherine
Individual
operational/managerial control2023-10-09
Kofstad, Mary
Individual
operational/managerial control2024-02-13
Okoli, Ike
Individual
operational/managerial control2023-03-06
Presley, Yolanda
Individual
operational/managerial control2025-01-06
Reid, Misty
Individual
operational/managerial control2025-01-02
Roderick, Glen
Individual
operational/managerial control2024-02-01
Schmitz, Bradley
Individual
operational/managerial control2023-09-01
Simpson, Andrew
Individual
operational/managerial control2024-06-01

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Pierce County.