Quick answers
- Where is Puget Sound Transitional Care?
- 2800 South 224th Street,, Des Moines, WA 98198, in King County, Washington.
- What is the phone number of Puget Sound Transitional Care?
- (206) 824-0600, as listed by Medicare (CMS).
- What is the Medicare star rating of Puget Sound Transitional Care?
- Medicare overall rating: 2 out of 5 stars (CMS data updated 2026-10-01).
- Has Puget Sound Transitional Care been fined?
- Medicare lists no fines for Puget Sound Transitional Care.
- What did inspectors find at Puget Sound Transitional Care?
- In its last three inspection cycles (May 19, 2023 to July 30, 2026), Medicare lists 64 health citations; the most serious was level J. 1 was level G or higher (actual harm or immediate jeopardy). See the list below (CMS data updated 2026-10-01).
Medicare ratings, explained
Star ratings are one piece of information. Visit, ask questions and talk with your doctor about what matters for your care.
Inspections, fines and staffing
In its last three inspection cycles (May 19, 2023 to July 30, 2026), Puget Sound Transitional Care had 64 health citations; the most serious was level J (immediate jeopardy to resident health or safety). 1 of them was level G or higher (actual harm or immediate jeopardy). Medicare lists no fines or payment denials for it in the last three years. Nurse staffing is 3.75 hours per resident per day; the Washington average is 4.42 and the national average is 3.90.
Source: Medicare (CMS) Provider Data Catalog, data updated October 1, 2026, retrieved November 13, 2026.
Inspection history: last three cycles
State inspectors visit about once a year and also investigate complaints. Each citation (deficiency) has a tag number and a letter, A to L. The letter shows how serious the problem was and how many residents it affected.
What the letters A to L mean
| Seriousness | Isolated (a few residents) | Pattern (some) | Widespread (many) |
|---|---|---|---|
| No actual harm, potential for minimal harm | A | B | C |
| No actual harm, potential for more than minimal harm | D | E | F |
| Actual harm to residents | G | H | I |
| Immediate jeopardy to resident health or safety | J | K | L |
Source: the scope and severity grid Medicare (CMS) uses for nursing home citations.
Most recent cycle: August 27, 2025 — 25 health citations
Inspections in this cycle: August 27, 2025 (standard health inspection); March 5, 2026 (complaint investigation); April 30, 2026 (complaint investigation); July 30, 2026 (complaint investigation).
Show 25 citations (levels A to F, no actual harm)
F0693 Level E
“Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.”
F0628 Level E
“Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.”
F0657 Level E
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0801 Level E
“Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.”
F0812 Level E
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0887 Level E
“Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.”
F0610 Level D
“Respond appropriately to all alleged violations.”
F0600 Level D
“Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.”
F0842 Level D
“Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.”
F0552 Level D
“Ensure that residents are fully informed and understand their health status, care and treatments.”
F0578 Level D
“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.”
F0636 Level D
“Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.”
F0641 Level D
“Ensure each resident receives an accurate assessment.”
F0644 Level D
“Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0676 Level D
“Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0679 Level D
“Provide activities to meet all resident's needs.”
F0684 Level D
“Provide appropriate treatment and care according to orders, resident’s preferences and goals.”
F0690 Level D
“Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.”
F0700 Level D
“Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.”
F0759 Level D
“Ensure medication error rates are not 5 percent or greater.”
F0761 Level D
“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.”
F0881 Level D
“Implement a program that monitors antibiotic use.”
F0908 Level D
“Keep all essential equipment working safely.”
Previous cycle: June 12, 2024 — 22 health citations
Inspections in this cycle: June 12, 2024 (standard health inspection); July 1, 2025 (complaint investigation).
F0678 Level J
“Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.”
immediate jeopardy to resident health or safety; isolated (a few residents) · Quality of Life and Care Deficiencies
Show 21 less serious citations (levels A to F)
F0812 Level F
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0726 Level E
“Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.”
F0578 Level E
“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.”
F0657 Level E
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0658 Level E
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0677 Level E
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0698 Level E
“Provide safe, appropriate dialysis care/services for a resident who requires such services.”
F0759 Level E
“Ensure medication error rates are not 5 percent or greater.”
F0847 Level E
“Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.”
F0609 Level D
“Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.”
F0610 Level D
“Respond appropriately to all alleged violations.”
F0584 Level D
“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.”
F0623 Level D
“Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.”
F0640 Level D
“Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.”
F0641 Level D
“Ensure each resident receives an accurate assessment.”
F0656 Level D
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0679 Level D
“Provide activities to meet all resident's needs.”
F0684 Level D
“Provide appropriate treatment and care according to orders, resident’s preferences and goals.”
F0688 Level D
“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.”
F0689 Level D
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
Earlier cycle: May 19, 2023 — 17 health citations
Inspections in this cycle: May 19, 2023 (standard health inspection); June 12, 2024 (complaint investigation).
Show 17 citations (levels A to F, no actual harm)
F0812 Level F
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0835 Level F
“Administer the facility in a manner that enables it to use its resources effectively and efficiently.”
F0553 Level E
“Allow resident to participate in the development and implementation of his or her person-centered plan of care.”
F0641 Level E
“Ensure each resident receives an accurate assessment.”
F0645 Level E
“PASARR screening for Mental disorders or Intellectual Disabilities”
F0655 Level E
“Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted”
F0850 Level E
“Hire a qualified full-time social worker in a facility with more than 120 beds.”
F0567 Level D
“Honor the resident's right to manage his or her financial affairs.”
F0582 Level D
“Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0684 Level D
“Provide appropriate treatment and care according to orders, resident’s preferences and goals.”
F0692 Level D
“Provide enough food/fluids to maintain a resident's health.”
F0740 Level D
“Ensure each resident must receive and the facility must provide necessary behavioral health care and services.”
F0756 Level D
“Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.”
F0760 Level D
“Ensure that residents are free from significant medication errors.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
F0881 Level D
“Implement a program that monitors antibiotic use.”
Citation descriptions are Medicare’s official wording. “From a complaint” means the citation came from a complaint investigation instead of the regular yearly inspection.
Full inspection reports on Medicare Care Compare →
Fire safety citations (38)
K0920 Level F
“Ensure proper usage of power strips and extension cords.”
K0372 Level D
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0741 Level D
“Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.”
E0015 Level F
“Address subsistence needs for staff and patients.”
E0018 Level F
“Establish procedures for tracking staff and patients during an emergency.”
E0030 Level F
“List the names and contact information of those in the facility.”
E0036 Level F
“Establish emergency prep training and testing.”
E0037 Level F
“Establish staff and initial training requirements.”
K0353 Level F
“Inspect, test, and maintain automatic sprinkler systems.”
K0211 Level F
“Keep aisles, corridors, and exits free of obstruction in case of emergency.”
K0355 Level E
“Properly select, install, inspect, or maintain portable fire extinguishes.”
K0363 Level E
“Install corridor and hallway doors that block smoke.”
K0920 Level E
“Ensure proper usage of power strips and extension cords.”
K0372 Level D
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0374 Level D
“Install smoke barrier doors that can resist smoke for at least 20 minutes.”
K0511 Level D
“Have properly installed electrical wiring and gas equipment.”
E0004 Level F
“Develop and maintain an Emergency Preparedness Program (EP).”
E0018 Level F
“Establish procedures for tracking staff and patients during an emergency.”
E0036 Level F
“Establish emergency prep training and testing.”
E0037 Level F
“Establish staff and initial training requirements.”
E0039 Level F
“Conduct testing and exercise requirements.”
K0291 Level F
“Install emergency lighting that can last at least 1 1/2 hours.”
K0324 Level F
“Provide properly protected cooking facilities.”
K0346 Level F
“Follow proper procedures when the fire alarm was out of service for more than 4 hours.”
K0354 Level F
“Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.”
K0531 Level F
“Have elevators that firefighters can control in the event of a fire.”
K0761 Level F
“To conduct inspection, testing and maintenance of fire doors by qualified individuals.”
K0926 Level F
“Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.”
K0353 Level E
“Inspect, test, and maintain automatic sprinkler systems.”
K0511 Level E
“Have properly installed electrical wiring and gas equipment.”
K0100 Level D
“Meet other general requirements.”
K0281 Level D
“Install proper backup exit lighting.”
K0321 Level D
“Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.”
K0363 Level D
“Install corridor and hallway doors that block smoke.”
K0372 Level D
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0374 Level D
“Install smoke barrier doors that can resist smoke for at least 20 minutes.”
K0541 Level D
“Install properly constructed and protected linen or trash chutes.”
K0923 Level D
“Have proper medical gas storage and administration areas.”
Staffing
Hours of nursing care per resident per day, from the payroll records nursing homes send to Medicare, next to the state and national averages.
| Measure | This home | Washington | National |
|---|---|---|---|
| Registered nurse (RN) hours per resident per day | 0.84 | 0.99 | 0.69 |
| Licensed practical nurse (LPN) hours per resident per day | 0.77 | 0.74 | 0.86 |
| Nurse aide hours per resident per day | 2.14 | 2.68 | 2.35 |
| Total nurse staff hours per resident per day | 3.75 | 4.42 | 3.90 |
| Total nurse staff hours per resident per day on the weekend | 3.37 | 3.82 | 3.43 |
| RN hours per resident per day on the weekend | 0.67 | 0.71 | 0.48 |
| Nursing staff turnover (per year) | 27.9% | 43.9% | 45.3% |
| RN turnover (per year) | 38.5% | 43.8% | 42.5% |
| Administrators who left in the last year | 1.0 | 0.5 | 0.5 |
Source: Medicare (CMS) Provider Information and State US Averages, data updated October 1, 2026.
Owners and operator
Part of a group of 347 nursing homes: The Ensign Group.
Legal business name: River Otter Healthcare LLC.
Owners and managers Medicare lists (4)
| Name | Role | Share | Since |
|---|---|---|---|
| Pennant Healthcare LLC | Direct owner | NOT APPLICABLE | November 21, 2022 |
| The Ensign Group Inc | Indirect owner | NOT APPLICABLE | November 21, 2022 |
| Actriv Healthcare LLC | Management company (operational or managerial control) | NOT APPLICABLE | August 1, 2023 |
| Eastside Healthcare Staffing LLC | Management company (operational or managerial control) | NOT APPLICABLE | August 1, 2023 |
Source: Medicare (CMS) Ownership file, data updated October 1, 2026. Only owners with an ownership interest and management companies are shown.
Compare with other nursing homes
Key facts
| Type | Nursing home |
|---|---|
| Certified beds | 165 |
| Average residents per day | 84.1 |
| Takes part in | Medicare and Medicaid |
| Ownership | For profit – corporation |
| Group or chain (affiliated entity) | The Ensign Group |
| Legal business name | River Otter Healthcare LLC |
| First approved by Medicare/Medicaid | 2004-02-02 |
| Resident and family councils | Resident council |
| Sprinklers in all required areas | Yes |
| Changed ownership in the last 12 months | No |
| Address | 2800 South 224th Street,, Des Moines, WA 98198 |
| County | King County |
| State | Washington |
| Phone | (206) 824‑0600 |
| CMS Certification Number | 505513 |
| Name in Medicare records | PUGET SOUND TRANSITIONAL CARE |
| Corrections | Report an error or suggest an update → |
What to ask when you call or visit
A general checklist for any nursing home, not advice about this one. Medicare also publishes guides on medicare.gov.
- Is the home certified by Medicare and/or Medicaid, and does it have a bed for the care you need (short-term rehab or long-term care)?
- Can you see the latest state inspection report? Ask how any problems found were fixed.
- How many nurses and aides work on each shift, at night and on weekends? Is there a registered nurse on site at all times?
- Which doctors see residents, and how often? What happens in a medical emergency, and which hospital is used?
- What therapy (physical, occupational, speech) is offered, and how many days a week?
- Are residents clean, dressed and taking part in activities? Do staff speak to them kindly and answer call lights quickly?
- What do the daily rate and extra services cost, and what do Medicare, Medicaid or your insurance pay? Ask for it in writing.
- Is there a resident council and a family council? How are complaints handled? Ask for the long-term care ombudsman’s contact.
- Are meals appetizing, and can the home meet special diets, language needs and religious or cultural preferences?
- Visit more than once, including at a mealtime or in the evening, without an appointment.
Other nursing homes nearby
By straight-line distance (not driving distance).
- Wesley Homes Des Moines Health Center1.0 mi · Des Moines, WA · 5 of 5 stars
- Judson Park Health Center1.2 mi · Des Moines, WA · 5 of 5 stars
- Benson Heights Rehabilitation Center4.7 mi · Kent, WA · 4 of 5 stars
- Valley View Skilled Nursing and Rehabilitation5.0 mi · Renton, WA · 3 of 5 stars
- Life Care Center of Federal Way5.3 mi · Federal Way, WA · 3 of 5 stars
Nearest hospital emergency rooms
- Highline Medical Center4.3 mi · Burien, WA · Acute Care Hospital
- Valley Medical Center4.8 mi · Renton, WA · Acute Care Hospital
- Multicare Auburn Medical Center7.2 mi · Auburn, WA · Acute Care Hospital
Sources
- Provider Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-01, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this provider
- Health Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Fire Safety Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Penalties — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Ownership — CMS, data updated 2026-10-01, retrieved 2026-11-13
- State US Averages — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Survey Summary — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Citation Code Look-up — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Inspection Dates — CMS, data updated 2026-10-01, retrieved 2026-11-13