Heartwood Extended Healthcare: Falsified Rehab Records - WA
The boots were never applied.
Inspectors from the Washington State Department of Health reviewed Heartwood's restorative program records for Resident 10 covering February 26 through March 27, 2026. What they found was a month of entries logging Prafos boot therapy to both legs, alongside range-of-motion exercises and fine motor tasks, all marked as completed. The records were thorough. They were also wrong.
The restorative aide who worked with Resident 10, identified in the inspection report as Staff Q, told inspectors on March 27 that the boots had not been applied. The reason, Staff Q said, was that the resident had refused to wear them. Staff Q's position was that the boot program should have been discontinued because of those refusals. It had not been discontinued. The documentation had simply continued to log the boots as part of an active program, marking each session with a notation that the activity did not occur, while an interdisciplinary team reviewed the records and found nothing to change.
There was a second problem buried in the same file. Heartwood's records showed no physician order for the Prafos boots at all. The boots were care planned, the Director of Nursing Services, Staff B, told inspectors on March 30. But there was no order. Staff B confirmed it directly: Resident 10 did not have an order for splints, braces, or Prafos boots.
What the facility did have was a progress note from March 26, the day before inspectors interviewed Staff Q, in which the interdisciplinary team reviewed Resident 10's restorative participation and concluded that programs were ongoing, goals were being worked toward, and no changes were needed at that time. The note listed bilateral Prafos boot application as an active program. It listed fine motor tasks. Neither had been documented as actually completed. The team's review, according to inspectors, was inaccurate.
Staff B, the Director of Nursing Services, did not dispute the inspectors' findings. She told them the restorative documentation should have been reviewed and updated to reflect that the boots weren't being applied. She said the interdisciplinary meetings should have caught the problem and addressed it. She said none of that happened. "This did not meet their expectations," she said, referring to her own facility's standards.
That acknowledgment is worth sitting with. The interdisciplinary team existed specifically to catch gaps like this one. It met. It reviewed the records. It signed off. The Director of Nursing said afterward that the team should have done more, but the meeting had already happened, the note had already been written, and the records had already been marked accurate.
The range-of-motion exercises, Staff Q said, were being provided and were documented in the computer system. That portion of the program appeared to be running as written. But the boots and the fine motor tasks, both listed in the interdisciplinary progress note as active components of the resident's care, were not happening and had not been documented as happening.
The inspection cited a deficiency under Washington's nursing home regulations. The harm level was classified as minimal harm or potential for actual harm, affecting few residents. Heartwood Extended Healthcare is located at 1649 East 72nd Street in Tacoma.
What the record doesn't answer is how long the gap between documentation and reality would have continued if inspectors hadn't come. The team had already looked at the records in March and found nothing to flag. The aide knew the boots weren't going on. Nobody had updated the program, discontinued the order that didn't exist, or told the team reviewing participation that the participation wasn't happening.
The chart said the boots went on every morning. They didn't.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Heartwood Extended Healthcare from 2026-03-30 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 18, 2026 · Our methodology
HEARTWOOD EXTENDED HEALTHCARE in TACOMA, WA was cited for violations during a health inspection on March 30, 2026.
The reason, Staff Q said, was that the resident had refused to wear them.
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.