Fir Lane Care
FIR LANE CARE in SHELTON, WA — inspection on February 24, 2026.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
discharge.
Staff A said they did not believe staff told Resident 1 they had to leave and the resident
505230 02/24/2026
Fir Lane Care 2430 North 13th Street Shelton, WA 98584
bed-hold policies.
interview and record review, the facility failed to notify the Long-Term Care Ombudsman of a facility
risk of being inappropriately discharged and lack of advocacy regarding their options and rights.
Findings included.Resident 1 was admitted to the facility on [DATE] with diagnoses including ankle infection, mood disorder and substance abuse. Resident 1 was discharged from the facility on 02/19/2026. Resident 1's Minimum Data Set Assessment, dated 01/04/2026, showed Resident 1 was cognitively intact.On 02/23/2026 at 3:09 PM, Resident 1 said Staff C, Social Service Director, told them they had to leave the facility after they had a verbal altercation with a nurse. Resident 1 said they did not want to discharge from the facility but did not believe it was optional. Resident 1 said they asked Staff C what to do because they did not know where to go and Staff C said they would work on a location. Resident 1 said Staff C notified them of where they were going at the last second. Resident 1 said they thought they were going to another facility and/or senior housing, but Staff C gave them a pamphlet of where they were being discharged to, and they thought it was like transitional housing for the homeless. Resident 1 said they thought they would have a bed at the facility and be able to stay at the place for a while until they could find something else. Resident 1 said they were surprised when the facility van dropped them off in the streets of Olympia at a homeless shelter. Resident 1 said the doors to the shelter were locked but there were a lot of people outside waiting to go in. Resident 1 said the shelter opened and allowed them to go in for a meal but there were no beds available for the night. Resident 1 said they were scared and had to wheel a long distance to find a restaurant open and contact family to come and pick them up.Resident 1's Transfer and Discharge notice, dated 02/18/2026, showed Resident 1 was discharged because the safety of other individuals in the facility was endangered due to the clinical or behavioral status of the resident.
The notice showed it was given to Resident 1 on 02/17/2026 and the date of discharge was 02/19/2026.Resident 1's Recapitulation of Stay, dated 02/19/2026, showed Resident 1's dc [discharge] was happening r/t [related to] Resident 1 was very aggressive and verbally abusive to staff on and off along with smelling ethoh [alcohol] on the resident.
The Recapitulation showed Resident 1 was being discharged to a shelter.Review of Resident 1's medical record on 02/25/2026, showed no documentation that the Long-Term Care Ombudsman had been notified of Resident 1's discharge.On 02/24/2026 at 3:40 PM, Staff C, Social Service Director, said they had not sent Resident 1's Transfer and Discharge Notice to the Long-Term Care Ombudsman, I send them at the end of the month.
Reference WAC 388-97-0120 (5)(b)
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.