North Auburn Care: Bed Hold Paperwork Failures - WA
That explanation, offered to inspectors during an April 21 survey, sits at the center of a deficiency cited against the Auburn, Washington facility.
Resident 7 was transferred to an acute care hospital on February 16, 2025, with a return anticipated. A Discharge Return Anticipated MDS from that same date confirmed the transfer. The facility completed a Transfer or Discharge Notice and Bed Hold Notification form, but what inspectors found when they reviewed it was a document with more blanks than answers. Under the section for bed hold duration, someone had written "TBD." The form had no place for the resident or their representative to sign consenting to or declining the bed hold. It showed no cost for holding the bed. There was no documentation anywhere in the resident's health record showing whether the guardian had ever been asked what they wanted.
Staff R, the business office manager, told inspectors the form had been completed by Staff C, a corporate nurse, and sent by email to Resident 7's guardian. But when inspectors asked for documentation showing the guardian had received it, or showing what decision the guardian had made, Staff R couldn't produce any. The email, if it was sent, left no retrievable trace.
Staff R also explained the facility's reasoning for the gaps. The resident "wouldn't do anything with paperwork if it was provided to them," Staff R said, and because the resident was on Medicaid, the facility hadn't seen a reason to offer a bed hold at all. The assumption was that a Medicaid resident couldn't pay for one.
That reasoning has a problem. The decision about whether to hold a bed belongs to the resident or their representative, not to a business office manager making a financial judgment on their behalf. A guardian was involved in this resident's care. There is no record that guardian was given a complete notification or asked to make a choice.
Staff R acknowledged to inspectors that they were responsible for ensuring bed hold forms were provided, that documentation of the resident's or representative's wishes ended up in the health record, and that when another staff member completed the form, it was their job to follow up. They had not followed up.
The Chief Nursing Officer, Staff D, confirmed the failure independently. In an interview at 12:56 PM on the day of inspection, Staff D said they had spoken with Staff C and could not produce a copy of the emailed notification for Resident 7's February transfer.
Nobody could.
The deficiency was cited at a level of minimal harm or potential for actual harm, affecting few residents. It references WAC 388-97-0120(4), Washington State's requirement governing transfer and discharge notices.
What the inspection record doesn't show is what Resident 7's guardian was told, if anything, in the days after that February hospitalization. It doesn't show whether the guardian knew they had a choice to make about the bed, or whether they learned about it only after the fact, or never. The form that was supposed to document that conversation had a blank where the answer should have been, and the email that was supposed to substitute for it appears to exist only in Staff R's account of what happened.
Resident 7's bed hold status, as of the transfer date, was listed as TBD.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for North Auburn Care from 2025-04-21 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
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Last verified: October 28, 2026 · Our methodology
North Auburn Care in AUBURN, WA was cited for violations during a health inspection on April 21, 2025.
That explanation, offered to inspectors during an April 21 survey, sits at the center of a deficiency cited against the Auburn, Washington facility.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.