Public Record
Bethany At Pacific
From CMS
Facility profile
- CMS overall rating
- 4 / 5
- Certified beds
- 80
- Avg. residents per day
- 74.9
*CMS Five-Star
*CMS
*CMS
Inspection record
On record from CMS
- Citations on record
- 81
- Inspections on file
- 10
- Last inspection
- 2025-06-11
*CMS
*CMS
*CMS
Citations
81 citations on record
Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
- 0628Generalpotential for harm
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- 0610Generalpotential for harm
Respond appropriately to all alleged violations.
- 0645Generalpotential for harm
PASARR screening for Mental disorders or Intellectual Disabilities
- 0646Generalpotential for harm
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
- 0658Generalpotential for harm
Ensure services provided by the nursing facility meet professional standards of quality.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0688Generalpotential for harm
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0690Generalpotential for harm
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- 0745Generalpotential for harm
Provide medically-related social services to help each resident achieve the highest possible quality of life.
- 0758Generalpotential for harm
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.
- 0761Generalpotential for harm
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.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0039Generalpotential for harm
Conduct testing and exercise requirements.
- 0025Generalpotential for harm
Create arrangements with other facilities to receive patients.
- 0020Generalpotential for harm
Establish policies and procedures including evacuation.
- 0006Generalpotential for harm
Conduct risk assessment and an All-Hazards approach.
- 0921Generalpotential for harm
Ensure that testing and maintenance of electrical equipment is performed.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0553Generalpotential for harm
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
- 0578Generalpotential for harm
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- 0582Generalpotential for harm
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- 0585Generalpotential for harm
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
- 0609Generalpotential for harm
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- 0604Generalpotential for harm
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
- 0022Generalpotential for harm
Establish policies and procedures for sheltering.
- 0554Generalpotential for harm
Allow residents to self-administer drugs if determined clinically appropriate.
- 0578Generalpotential for harm
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- 0584Generalpotential for harm
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- 0641Generalpotential for harm
Ensure each resident receives an accurate assessment.
- 0644Generalpotential for harm
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- 0645Generalpotential for harm
PASARR screening for Mental disorders or Intellectual Disabilities
- 0656Generalpotential for harm
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- 0657Generalpotential for harm
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0688Generalpotential for harm
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- 0692Seriousactual harm
Provide enough food/fluids to maintain a resident's health.
- 0745Generalpotential for harm
Provide medically-related social services to help each resident achieve the highest possible quality of life.
- 0756Generalpotential for harm
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- 0882Generalpotential for harm
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- 0947Generalpotential for harm
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0007Generalpotential for harm
Address patient/client population and determine types of services needed.
- 0015Generalpotential for harm
Address subsistence needs for staff and patients.
- 0020Generalpotential for harm
Establish policies and procedures including evacuation.
- 0023Generalpotential for harm
Establish policies and procedures for medical documentation.
- 0026Generalpotential for harm
Establish roles under a Waiver declared by secretary.
- 0029Generalpotential for harm
Develop a communication plan.
- 0032Generalpotential for harm
Provide primary/alternate means for communication.
- 0033Generalpotential for harm
Establish methods for sharing information.
- 0034Generalpotential for harm
Provide a means of sharing information on occupancy/needs.
- 0039Generalpotential for harm
Conduct testing and exercise requirements.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0511Generalpotential for harm
Have properly installed electrical wiring and gas equipment.
- 0921Generalpotential for harm
Ensure that testing and maintenance of electrical equipment is performed.
- 0623Generalpotential for harm
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- 0625Generalpotential for harm
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.
- 0640Generalpotential for harm
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
- 0584Generalpotential for harm
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- 0842Generalpotential for harm
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- 0779Generalpotential for harm
Keep signed and dated reports of x-rays and other diagnostic services in the residents record.
- 0775Generalpotential for harm
Keep complete, dated laboratory records in the resident's record.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0585Generalpotential for harm
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
- 0033Generalpotential for harm
Establish methods for sharing information.
- 0345Generalpotential for harm
Have approved installation, maintenance and testing program for fire alarm systems.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0374Generalpotential for harm
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- 0030Generalpotential for harm
List the names and contact information of those in the facility.
- 0211Generalpotential for harm
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- 0580Generalpotential for harm
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- 0645Generalpotential for harm
PASARR screening for Mental disorders or Intellectual Disabilities
- 0656Generalpotential for harm
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0692Generalpotential for harm
Provide enough food/fluids to maintain a resident's health.
- 0511Generalpotential for harm
Have properly installed electrical wiring and gas equipment.
- 0923Generalpotential for harm
Have proper medical gas storage and administration areas.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0006Generalpotential for harm
Conduct risk assessment and an All-Hazards approach.
- 0582Generalpotential for harm
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- 0660Generalpotential for harm
Plan the resident's discharge to meet the resident's goals and needs.
FAQ
Questions and answers
- What is Bethany At Pacific?
- Bethany At Pacific is a Medicare- and Medicaid-certified nursing home in Everett, WA, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 505404.
- What is the CMS rating for Bethany At Pacific?
- Bethany At Pacific has a CMS overall rating of 4 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
- How many beds does Bethany At Pacific have?
- Bethany At Pacific is certified for 80 beds. It serves an average of 74.9 residents per day.
- How many citations does Bethany At Pacific have?
- Bethany At Pacific has 81 citations on record from CMS health inspections, each tied to a federal deficiency tag.
- When was Bethany At Pacific last inspected?
- Bethany At Pacific was last inspected on June 11, 2025. CMS surveys nursing homes about once a year and after complaints.
- What can I do if I have concerns about care at this facility?
- Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.
*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.
/nursing-home/505404-bethany-at-pacific