Ballard Center
Inspection Findings
F-Tag F0628
F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
prior to Resident 2 and 3 leaving the facility. Staff B stated, I don't' [do not] see a nurses' note saying that
they discussed it and that I don't [do not] see it documented or what they gave the resident when they left.
A joint record review of Resident 3's EHR did not show documentation of the facility's attempts to provide Resident 4 with a discharge summary and/or discussion regarding reconciliation of medications prior to leaving the facility. When asked if there was documentation that a discharge summary was offered to Resident 4 prior to leaving, Staff B stated No. In an interview on 11/14/2025 at 1:15 PM, Staff A, Director of Nursing, stated that they expected AMA discharges to be made as safe as possible and that discharge summaries with a reconciliation of medication would be offered and documented. Reference: (WAC) 388-97-0080 (7)(a)(b).
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Ballard Center
820 Northwest 95th Street Seattle, WA 98117
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0678
F 0678 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
from. Staff C further stated that verification of Resident 1's code status via physician orders was not performed and that No, we did not, went to the Miscellaneous Tab to check. When asked if physician orders
in Resident 1's EHR were signed/approved orders by a provider, Staff C stated Yes, we didn't [did not] get a chance to see that. In a follow up interview and joint record review on [DATE REDACTED] at 11:22 AM, Staff B, stated that staff verified a resident's code status during an emergency by referring to the master copy of the completed POLST that was kept in a binder at each nurses' station. Staff B stated that a resident's code status could be referenced in the resident's EHR via the resident profile and physician orders. A joint record
review of Resident 1's completed POLST form showed DNAR was elected. Further joint record review of Resident 1's physician orders and [DATE REDACTED] MAR showed an order dated [DATE REDACTED] for DNR and that Resident 1's code status was transcribed on pages of their MAR. Staff C stated, Every page on the MAR has the advance directives, and that The expectation is to go by what the [physician] orders say. When asked if Resident 1's advance directive for DNAR was honored on [DATE REDACTED], Staff B stated, No it was not. In an
interview on [DATE REDACTED] at 1:15 PM, Staff A, Director of Nursing, stated that advance directives including the POLST form were discussed with residents on admission. Staff A stated that they expected staff to verify a resident's code status by the POLST form during an emergency and that Resident 1's POLST form was not available for the nurses' to verify. STAFF E Review of [DATE REDACTED] Licensed Nurses staffing schedule showed Staff E, Licensed Practical Nurse, was scheduled to work for a total of 11 days for Day shift and 12 days for Evening shift. Review of [DATE REDACTED] Licensed Nurses staffing schedule showed Staff E was scheduled to work for total of 10 days for Day shift and 14 days for Evening shift. In an interview on [DATE REDACTED] at 10:18 AM, Staff E stated they received CPR training from another workplace. Staff E further stated that their CPR certification had lapsed and that Now it's [it is] due. STAFF FReview of the facility's [DATE REDACTED] Certified Nursing Assistant (CNA) staffing schedule showed Staff F, CNA, was scheduled to work for a total of 20 days. In an
interview on [DATE REDACTED] at 10:15 AM, Staff F stated that they were scheduled to receive CPR training but that it was postponed. Staff F further stated that they were last trained on performing CPR maybe years ago, and long time ago. On [DATE REDACTED] at 12:10 PM, documentation of current CPR certifications for Staff E and Staff F were requested from Staff G, Payroll. In a follow-up interview at 3:10 PM, Staff G and Staff A stated they would provide requested CPR certifications as able. In an interview on [DATE REDACTED] at 1:15 PM, Staff A stated that they expected licensed staff would complete the required CPR training. On [DATE REDACTED] at 6:24 PM, Staff A provided CPR certifications for Staff E and Staff F that were completed on [DATE REDACTED].Reference: (WAC) 388-97-1060(1) -0280(1).
Event ID:
Facility ID:
If continuation sheet
BALLARD CENTER in SEATTLE, WA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in SEATTLE, WA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from BALLARD CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.