Puget Sound Care
4001 Capitol Mall Dr Southwest, Olympia, WA 98502 · Thurston County · 108 certified beds · avg 95 residents/day · certified since Sep 27, 1985
Part of chain: CALDERA CARE (6 facilities, chain avg rating 2.8★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 4/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Mar 28, 2024 · F-0760 · triggered by a complaint
The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.
Why it matters: A serious medication error can cause real harm, hospitalization, or worse.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Feb 12, 2024 (Past Non-Compliance)
All citations in the current public record (21)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| May 8, 2026 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Jan 23, 2026 | E · Potential for harm, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not properly notify residents about the balance of money it holds for them, or failed to return those funds when a resident was discharged, evicted, or died. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jul 1, 2025 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · from a complaint |
| Nov 7, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Nov 7, 2024 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Nov 7, 2024 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Nov 7, 2024 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Mar 28, 2024 | ▲ G · Actual harm, one-off | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint |
| Oct 13, 2023 | E · Potential for harm, repeated | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Oct 13, 2023 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Oct 13, 2023 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Oct 13, 2023 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Oct 13, 2023 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Oct 13, 2023 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (4 → 8).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 6 | 0 | E |
| 2024 | 5 | 1 | G ▲ |
| 2025 | 1 | 0 | F |
| 2026 | 9 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
1 fine totaling $8,018.
| Date | Type | Amount / length |
|---|---|---|
| Mar 28, 2024 | Fine | $8,018 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Washington avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.33 | 4.24 | 3.95 | top 31% in Washington; top 28% in the U.S. |
| Registered Nurse hours | 0.59 | 0.91 | 0.69 | bottom 11% in Washington; top 50% in the U.S. |
| Weekend total nurse staffing | 3.64 | 3.69 | 3.50 | top 36% in Washington; top 36% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.30 | 0.67 | 0.48 | bottom 4% in Washington; bottom 33% in the U.S. |
| Total nursing staff turnover (%) | 56.0 | 45.1 | 45.8 | bottom 21% in Washington; bottom 23% in the U.S. |
| RN turnover (%) | 36.4 | 45.4 | 42.9 | top 34% in Washington; top 40% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.02, RN 0.55, weekend 3.38. Staffing rating: 3/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: 4/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Cornerstone 18 Operations Ajh LLC | Organization | 5% or Greater Indirect Ownership Interest | — | 05/07/2021 |
| Cornerstone 18 Operations LLC | Organization | 5% or Greater Indirect Ownership Interest | — | 05/07/2021 |
| Handler, Asher | Individual | 5% or Greater Indirect Ownership Interest | — | 05/07/2021 |
| PNW Healthcare Holdings, LLC | Organization | 5% or Greater Direct Ownership Interest | 100% | 06/30/2017 |
| Wolmark, Chaim | Individual | 5% or Greater Indirect Ownership Interest | — | 05/07/2021 |
| 4001 Capital Mall LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Chheda, Neel | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/07/2021 |
| Chheda, Neel | Individual | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Cornerstone 18 LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Handler, Asher | Individual | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| KH CC Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Oscherowitz, Raphael | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/07/2021 |
| Oscherowitz, Raphael | Individual | Corporate Officer | NOT APPLICABLE | 05/07/2021 |
| Oscherowitz, Raphael | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/07/2021 |
| Oscherowitz, Raphael | Individual | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Shepard, Addison | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/07/2021 |
| Shepard, Addison | Individual | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Stone 18 Ajh LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Stone 18 Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
| Stone Wa 18 LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2021 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What systems do you use to prevent medication errors, and what happens when one occurs?"
- "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "If you manage my family member's personal funds, how often will we get statements and how quickly are funds returned?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
- "What alternatives do you try before using bed rails, and how do you involve families in that decision?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Regency Olympia Rehabilitation and Nursing Center | 3.4 mi | Olympia, WA | ★★★★★ | 4/5 | |
| Woodard Creek Health & Rehabilitation | 5.2 mi | Olympia, WA | ★☆☆☆☆ | 1/5 | SFF |
| Olympia Transitional Care and Rehabilitation | 5.2 mi | Olympia, WA | ★★★☆☆ | 3/5 | |
| Panorama City Conv & Rehab Ctr | 5.7 mi | Lacey, WA | ★★★★★ | 4/5 | |
| Lacey Post Acute & Rehabilitation | 6.3 mi | Lacey, WA | ★★★★☆ | 3/5 | |
| Crystal Cove Post Acute | 7.6 mi | Lacey, WA | —/5 | SFF | |
| Fir Lane Care | 15.0 mi | Shelton, WA | ★☆☆☆☆ | 1/5 | |
| Shelton Health and Rehabilitation | 15.3 mi | Shelton, WA | ★★☆☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 505299.