
Report
TheVardellReport
Orchard Park Health Care & Rehab Center
Skilled nursing facility and nursing facility
4755 South 48Th
Tacoma, WA 98409

TheVardellReport
Skilled nursing facility and nursing facility
4755 South 48Th
Tacoma, WA 98409
Life by Vardell Presents
The deeper story, beautifully organized. Available records, historical context, and questions worth asking.
This report is free. Vardell does not certify, grade or endorse; it shows what the record documents.
The Essentials
Across 22 inspections from October 2023 to August 2026, state surveyors documented 136 findings at Orchard Park Health Care & Rehab Center; 127 have a recorded correction and 9 await one; CMS lists 3 enforcement actions in the window.
* Partial year, through October 1, 2026.
| Year | Inspections | Findings | Of which, actual harm (level G or above) |
|---|---|---|---|
| 2023 | 1 | 9 | 0 |
| 2024 | 7 | 46 | 1 |
| 2025 | 5 | 22 | 1 |
| 2026 | 9 | 59 | 6 |
Chronology
Every inspection in the record window, newest first. A finding is a deficiency an inspector cited. CMS publishes what a complaint investigation cited, not what the complaint alleged.
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
9 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
12 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
28 findings
The same visit included a complaint investigation.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
18 findings
Enforcement Action
Civil money penalty, $34,671 imposed June 12, 2025. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of June 12, 2025, the nearest before the penalty date.
Enforcement Action
Civil money penalty, $165,315 imposed May 1, 2026. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of June 12, 2025, the nearest before the penalty date.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
34 findings
The same visit included a complaint investigation.
Enforcement Action
Civil money penalty, $101,384 imposed September 9, 2024. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of September 9, 2024, the nearest before the penalty date.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
9 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
Severity levels follow the CMS scope and severity grid. A–C: potential for minimal harm. D–F: no actual harm, potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy.
Context
A repeated citation can merit attention, but context and corrective action must be reviewed before drawing a conclusion.
Inspectors cited F677 in October 2023, January 2024, June 2024, April 2025 and July 2026. This citation covers help with bathing, dressing, eating and toileting for residents who cannot manage alone. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F689 in September 2024, June 2025, June 2026, July 2026 and August 2026. This citation covers whether residents are protected from accident hazards and supervised closely enough to prevent accidents, including falls. The most serious of these was recorded at level H (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F658 in October 2023, July 2024, September 2024 and June 2025. This citation covers whether the home’s services meet professional standards of quality. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F686 in April 2024, September 2024, January 2026 and June 2026. This citation covers how the home prevents and treats pressure injuries (bedsores). None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F600 in June 2026, July 2026 and August 2026. This citation covers whether residents are protected from abuse and neglect by anyone. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F641 in September 2024, June 2025 and June 2026. This citation covers whether each resident’s assessment correctly records their condition. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F645 in September 2024, June 2025 and June 2026. This citation covers the required screening for mental illness or intellectual disability before admission (PASARR). None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F656 in June 2025, January 2026 and June 2026. This citation covers whether each resident has a written care plan that meets their needs, with goals that can be measured. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F688 in October 2023, September 2024 and March 2026. This citation covers care that keeps or improves a resident’s movement and mobility. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F725 in October 2023, June 2026 and July 2026. This citation covers whether there are enough nurses and aides to meet residents’ needs, with a licensed nurse in charge on each shift. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F757 in October 2023, September 2024 and June 2026. The agency describes it this way: Ensure each resident’s drug regimen must be free from unnecessary drugs. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F790 in September 2024, June 2025 and June 2026. The agency describes it this way: Provide routine and 24-hour emergency dental care for each resident. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F806 in September 2024, June 2025 and May 2026. The agency describes it this way: Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F880 in September 2024, June 2025 and June 2026. This citation covers hand hygiene, isolation practice and the home’s infection-prevention program. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F552 in September 2024 and July 2026. The agency describes it this way: Ensure that residents are fully informed and understand their health status, care and treatments. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F605 in June 2025 and June 2026. The agency describes it this way: Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F655 in September 2024 and June 2026. This citation covers the baseline care plan for a new resident’s immediate needs, due within 48 hours of admission. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F657 in September 2024 and June 2026. This citation covers whether care plans are written on time and revised by a team that includes the resident’s caregivers. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F692 in September 2024 and June 2026. This citation covers whether residents get enough food and fluids to stay healthy. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F695 in September 2024 and June 2025. This citation covers oxygen, breathing treatments and other respiratory care. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F698 in September 2024 and June 2026. This citation covers care for residents who need dialysis. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F745 in June 2026 and July 2026. The agency describes it this way: Provide medically-related social services to help each resident achieve the highest possible quality of life. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F756 in September 2024 and June 2026. The agency describes it this way: Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F759 in October 2023 and September 2024. This citation covers whether medication errors stayed under 5 percent when inspectors watched medications being given. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F791 in September 2024 and June 2025. The agency describes it this way: Provide or obtain dental services for each resident. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F825 in September 2024 and August 2025. The agency describes it this way: Provide or get specialized rehabilitative services as required for a resident. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
F550 was cited in August 2026. This citation covers residents’ right to dignity, to make their own choices and to communicate. The most serious was level G (actual harm). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F569 was cited in August 2026. The agency describes it this way: Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. The most serious was level D (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F584 was cited in October 2023, May 2024, September 2024, June 2026 and August 2026. This citation covers whether rooms and shared spaces are kept safe, clean, comfortable and homelike. The most serious was level E (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F585 was cited in June 2024, September 2024 and August 2026. This citation covers residents’ right to voice grievances without reprisal, and the home’s process for resolving them. The most serious was level E (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F609 was cited in September 2024, March 2026 and August 2026. This citation covers whether suspected abuse, neglect or theft is reported to the authorities on time, with the results of the home’s investigation. The most serious was level E (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F610 was cited in October 2023, April 2024, September 2024, June 2025 and August 2026. This citation covers how the home responds to and investigates an allegation of abuse, neglect or mistreatment. The most serious was level G (actual harm). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F684 was cited in October 2023, July 2024, September 2024, June 2025, May 2026, July 2026, August 2026 and August 2026. This citation covers whether residents receive the treatment their orders, preferences and goals call for. The most serious was level G (actual harm). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F694 was cited in August 2026. The agency describes it this way: Provide for the safe, appropriate administration of IV fluids for a resident when needed. The most serious was level D (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
F803 was cited in September 2024 and August 2026. The agency describes it this way: Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. The most serious was level E (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
For Your Next Visit
Bring these to the tour. Each one comes from something in the record; the reason is under the question.
How long do residents usually wait for help with bathing, dressing or the bathroom, and how is that tracked?
Help With Daily Living: cited in five inspections, most seriously at level E.
What changed in fall prevention and supervision after the last citation, and how do you check that it is still working?
Accident Hazards and Supervision: cited in five inspections, most seriously at level H.
How do you check that nurses and aides follow professional standards, and what happens when they do not?
Professional Standards: cited in four inspections, most seriously at level E.
How often are residents checked for pressure injuries and repositioned, and who is responsible for it?
Pressure Injury Care: cited in four inspections, most seriously at level E.
What happened after the abuse or neglect citation, and what changed in training or supervision?
Protection From Abuse and Neglect: cited in three inspections, most seriously at level G.
Who completes resident assessments, and how are they checked for accuracy?
Accurate Assessments: cited in three inspections, most seriously at level E.
Was the required pre-admission screening done for every resident, and how is it tracked?
Pre-Admission Screening: cited in three inspections, most seriously at level E.
How is a care plan written and reviewed here, and how do families take part in it?
Care Plans: cited in three inspections, most seriously at level D.
What do you do to keep residents moving, and who provides range-of-motion care?
Mobility and Range of Motion: cited in three inspections, most seriously at level G.
How many nurses and aides are on each shift, including nights and weekends, for the unit we are considering?
Nursing Staff Levels: cited in three inspections, most seriously at level E.
What changed after F757 was cited, and how do you check it now?
Citation F757: cited in three inspections, most seriously at level E.
What changed after F790 was cited, and how do you check it now?
Citation F790: cited in three inspections, most seriously at level D.
What changed after F806 was cited, and how do you check it now?
Citation F806: cited in three inspections, most seriously at level G.
Who leads infection control here, and how often are hand-hygiene and isolation practices audited?
Infection Control: cited in three inspections, most seriously at level E.
What changed after F552 was cited, and how do you check it now?
Citation F552: cited in two inspections, most seriously at level E.
What changed after F605 was cited, and how do you check it now?
Citation F605: cited in two inspections, most seriously at level D.
What happens in the first 48 hours after admission, and who writes the first care plan?
The First 48 Hours: cited in two inspections, most seriously at level D.
How often are care plans revised, and who takes part in the review?
Care Plan Timing and Review: cited in two inspections, most seriously at level E.
How are weight and fluid intake tracked, and what happens when a resident starts losing weight?
Nutrition and Hydration: cited in two inspections, most seriously at level D.
Who manages oxygen and breathing treatments on each shift, and how is the equipment checked?
Respiratory Care: cited in two inspections, most seriously at level E.
How is dialysis care coordinated, and who monitors residents before and after treatment?
Dialysis Care: cited in two inspections, most seriously at level E.
What changed after F745 was cited, and how do you check it now?
Citation F745: cited in two inspections, most seriously at level E.
What changed after F756 was cited, and how do you check it now?
Citation F756: cited in two inspections, most seriously at level E.
How are medication passes checked, and what happens when an error is found?
Medication Error Rate: cited in two inspections, most seriously at level E.
What changed after F791 was cited, and how do you check it now?
Provide or obtain dental services for each resident: cited in two inspections, most seriously at level D.
What changed after F825 was cited, and how do you check it now?
Citation F825: cited in two inspections, most seriously at level D.
How do staff learn each resident’s preferences, and how is a complaint about dignity handled?
Dignity and Resident Rights: cited in one inspections, most seriously at level G. The August 5, 2026 citation has no recorded correction date.
What changed after F569 was cited, and how do you check it now?
Citation F569: cited in one inspections, most seriously at level D. The August 5, 2026 citation has no recorded correction date.
What was done about the cleanliness citation, and how are rooms and shared spaces checked now?
A Clean, Homelike Setting: cited in five inspections, most seriously at level E. The August 5, 2026 citation has no recorded correction date.
How do we file a grievance, who answers it, and how quickly?
Grievances: cited in three inspections, most seriously at level E. The August 5, 2026 citation has no recorded correction date.
How are staff trained to report suspected abuse or neglect, and who reports it to the state?
Reporting Suspected Abuse: cited in three inspections, most seriously at level E. The August 5, 2026 citation has no recorded correction date.
When an allegation is made, who investigates it, and how are residents protected in the meantime?
Investigating Alleged Violations: cited in five inspections, most seriously at level G. The August 5, 2026 citation has no recorded correction date.
How do nurses make sure a doctor’s orders are carried out, and how are families told when something is missed?
Quality of Care: cited in eight inspections, most seriously at level G. The August 5, 2026 citation has no recorded correction date.
What changed after F694 was cited, and how do you check it now?
Citation F694: cited in one inspections, most seriously at level D. The August 5, 2026 citation has no recorded correction date.
What changed after F803 was cited, and how do you check it now?
Citation F803: cited in two inspections, most seriously at level E. The August 5, 2026 citation has no recorded correction date.
What led to the 2026 fine, and has it been paid?
A $165,315 civil money penalty was imposed May 1, 2026. CMS publishes the fine, not whether it has been paid. The record holds three enforcement actions in the window.
The Evidence
Inspection results and penalties are published by the Centers for Medicare & Medicaid Services from surveys conducted by the Washington state survey agency.
Washington state survey agency
Inspection Oct 27, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jan 31, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Apr 2, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection May 20, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jun 7, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jul 11, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Sep 9, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Sep 19, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Apr 23, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jun 12, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jul 30, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Aug 8, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Aug 25, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jan 12, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Mar 19, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Mar 26, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection May 1, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection May 14, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jun 1, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Jul 15, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Aug 5, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Washington state survey agency
Inspection Aug 19, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Centers for Medicare & Medicaid Services
Published Oct 1, 2026 · Retrieved Nov 1, 2026
Centers for Medicare & Medicaid Services · 505093
Published Oct 1, 2026 · Retrieved Nov 1, 2026
Record windowOctober 27, 2023 – October 1, 2026
Historical coverage varies by agency and location. Missing records do not mean that no complaint or violation occurred.
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