Park Shore
1630 43rd Avenue East, Seattle, WA 98112


Park Shore is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 505493. The address is 1630 43rd Avenue East, Seattle, WA 98112. The zip code is 98112. The phone number is 2063290770.


Park Shore · 1630 43rd Avenue East, Seattle, WA 98112

Federal Provider Number 505493
Provider Name PARK SHORE
Address 1630 43RD AVENUE EAST
SEATTLE, WA 98112
Phone Number 2063290770
SSA County Code 160
County Name King
Ownership Type Non profit - Corporation
Certified Beds 28
Certified Beds Residents 22
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST
Date First Approved to Provide Medicare Medicaid Services 08/10/1995
Continuing Care Retirement Community true
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 3.03636
Reported LPN Staffing Hours per Resident per Day 0.83409
Reported RN Staffing Hours per Resident per Day 0.51818
Reported Licensed Staffing Hours per Resident per Day 1.35227
Reported Total Nurse Staffing Hours per Resident per Day 4.38863
Reported Physical Therapist Staffing Hours per Resident Per Day 0.09091
Expected CNA Staffing Hours per Resident per Day 2.66569
Expected LPN Staffing Hours per Resident per Day 0.63886
Expected RN Staffing Hours per Resident per Day 1.10361
Expected Total Nurse Staffing Hours per Resident per Day 4.40815
Adjusted CNA Staffing Hours per Resident per Day 2.79489
Adjusted LPN Staffing Hours per Resident per Day 1.08365
Adjusted RN Staffing Hours per Resident per Day 0.35084
Adjusted Total Nurse Staffing Hours per Resident per Day 4.01305
Cycle 1 Standard Survey Health Date 12/15/2016
Cycle 2 Total Number of Health Deficiencies 11
Cycle 2 Number of Standard Health Deficiencies 11
Cycle 2 Health Deficiency Score 44
Cycle 2 Standard Health Survey Date 09/21/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 44
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Health Deficiency Score 16
Cycle 3 Standard Health Survey Date 10/03/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 16
Total Weighted Health Survey Score 17.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Park Shore

Owner Name Role Association Date
BARD, WESLEY (Individual) MANAGING EMPLOYEE since 06/23/2010
BRIAN CALDWELL, BONNIE (Individual) DIRECTOR since 06/23/2010
CONGER, CAROLE (Individual) DIRECTOR since 06/23/2010
DIEKEMA, DOUGLAS (Individual) DIRECTOR since 06/23/2010
EMERY, JOYCE (Individual) DIRECTOR since 06/23/2010
ESHELMAN, JOHN (Individual) DIRECTOR since 06/23/2010
HOULAHAN, GARY (Individual) DIRECTOR since 06/23/2010
JAMES, HEATHER (Individual) DIRECTOR since 06/23/2010
JOHNSTON, THOMAS (Individual) DIRECTOR since 06/23/2010
KELLEGREW, FREDERICK (Individual) DIRECTOR since 06/23/2010
KELLEY, LUCILLE (Individual) DIRECTOR since 06/23/2010
MATTHEWS, RICHARD (Individual) DIRECTOR since 06/23/2010
MELHORN, JAMES (Individual) DIRECTOR since 06/23/2010
MITCHELL, ROBERT (Individual) DIRECTOR since 06/23/2010
ROBINSON, GREGORY (Individual) DIRECTOR since 06/23/2010
VASILATOS, THOMAS (Individual) DIRECTOR since 06/23/2010

98112 · Nursing Home

Bailey-boushay House 2720 East Madison, Seattle, WA 98112

Seattle · Nursing Home

Kindred Nursing and Rehabilitation - Arden 16357 Aurora Avenue North, Seattle, WA 98133
Columbia Lutheran Home 4700 Phinney Avenue North, Seattle, WA 98103
Sea Mar Community Care Center 1040 South Henderson Street, Seattle, WA 98108
Anderson House 17127 15th Avenue Northeast, Seattle, WA 98155
Providence Mount St Vincent 4831 35th Avenue Southwest, Seattle, WA 98126
Washington Center for Comprehe 2821 South Walden Street, Seattle, WA 98144
Bailey-boushay House 2720 East Madison, Seattle, WA 98112
Ballard Center 820 Northwest 95th Street, Seattle, WA 98117
Fircrest School, Pat N 15230-15th Northeast, Seattle, WA 98155
Hearthstone, The 6720 East Green Lake Way North, Seattle, WA 98103
Paramount Rehabilitation and Nursing 2611 South Dearborn, Seattle, WA 98144
Kin On Health Care Center 4416 South Brandon Street, Seattle, WA 98118
Caroline Kline Galland Home 7500 Seward Park Avenue South, Seattle, WA 98118
Saint Anne Nursing and Rehabilitation Center 3540 Northeast 110th Street, Seattle, WA 98125
Kindred Seattle - First Hill 1334 Terry Ave, Seattle, WA 98101
Ida Culver House Broadview Ncc 12509 Greenwood Avenue North, Seattle, WA 98133
Kenney, The 7125 Fauntleroy Way Southwest, Seattle, WA 98136
Mirabella Seattle 116 Fairview Avenue N, Seattle, WA 98109
Cristwood Nursing and Rehabilitation 19301 Kings Garden Drive North, Seattle, WA 98133
Seattle Medical Post Acute Care 555 16th Avenue, Seattle, WA 98122
Health and Rehabilitation of North Seattle 13333 Greenwood Avenue North, Seattle, WA 98133
Keiro Northwest 1601 East Yesler Way, Seattle, WA 98122
Shoreline Health and Rehabilitation 2818 Northeast 145th Street, Seattle, WA 98155
Park Ridge Care Center 1250 Northeast 145th Street, Seattle, WA 98155
Kindred Seattle - Northgate 10631 8th Ave Ne, Seattle, WA 98125
Park West Care Center 1703 California Avenue Southwest, Seattle, WA 98116
Bayview Manor 11 West Aloha Street, Seattle, WA 98119
Richmond Beach Rehab 19235 - 15th Avenue Northwest, Seattle, WA 98177
The Terraces At Skyline 715 9th Avenue, Seattle, WA 98104
Queen Anne Healthcare 2717 Dexter Avenue North, Seattle, WA 98109
Foss Home & Village 13023 Greenwood Avenue North, Seattle, WA 98133

WA · Nursing Home

Booker Rest Home Annex 1012 South 3rd Street, Dayton, WA 99328
Springs At Pacific Regent, The 919-109th Avenue Northeast, Bellevue, WA 98004
Highland Health and Rehabilitation 2400 Samish Way, Bellingham, WA 98225
Colonial Vista Post-acute & Rehab Center 625 Okanogan, Wenatchee, WA 98801
Newport Community Hospital Ltc 714 West Pine Street, Newport, WA 99156
Paramount Rehabilitation and Nursing 2611 South Dearborn, Seattle, WA 98144
Corwin Center At Emerald Heights 10901 - 176th Circle Northeast, Redmond, WA 98052
Alaska Gardens Health and Rehabilitation 6220 South Alaska Street, Tacoma, WA 98408
Avalon Health & Rehabilitation Center - Pasco 2004 N 22nd Avenue, Pasco, WA 99301
Providence St Joseph Care Center 17 East 8th Avenue, Spokane, WA 99202
Regency Care Center At Monroe 1355 West Main Street, Monroe, WA 98272
Spokane Veterans Home 222 East Fifth, Spokane, WA 99202
Avamere At Pacific Ridge 3625 East B Street, Tacoma, WA 98404
Aldercrest Health & Rehab Center 21400 72nd Avenue West, Edmonds, WA 98026
Rainier Rehabilitation 920 12th Avenue Southeast, Puyallup, WA 98372
Orchard Park Health Care & Rehab Center 4755 South 48th, Tacoma, WA 98409
Gardens On University, The 414 S University Rd, Spokane, WA 99206
Queen Anne Healthcare 2717 Dexter Avenue North, Seattle, WA 98109
Ballard Center 820 Northwest 95th Street, Seattle, WA 98117
Warm Beach Health Care Center 20420 Marine Drive Northwest, Stanwood, WA 98292
North Cascades Health and Rehabilitation Center 4680 Cordata Parkway, Bellingham, WA 98226
Sullivan Park Care Center 14820 East Fourth, Spokane, WA 99216
Vashon Community Care Center 15333 Vashon Highway Southwest, Vashon, WA 98070
North Auburn Rehab & Health Center 2830 I Street Northeast, Auburn, WA 98002
Covenant Shores Health Center 9107 Fortuna Drive, Mercer Island, WA 98040
Beacon Hill Rehabilitation 128 Beacon Hill Drive, Longview, WA 98632
Yakima Valley School 609 Speyers Road, Selah, WA 98942
Touchmark On South Hill Nursing 2929 South Waterford Drive, Spokane, WA 99203
Avalon Care Center - Pullman Northwest 1310 Deane, Pullman, WA 99163
Regency Omak 901 Shumway Rd, Omak, WA 98841
Issaquah Nursing and Rehabilitation Center 805 Front Street, Issaquah, WA 98027
Columbia Basin Hospital 200 Nat Washington Way, Ephrata, WA 98823
Regency At The Park 420 Southeast Myra Road, College Place, WA 99324
Shelton Health & Rehab Center 153 Johns Court, Shelton, WA 98584
Buena Vista Healthcare 151 Buena Vista Drive, Colville, WA 99114
Manor Care Health Services-spo North 6025 Assembly, Spokane, WA 99205
Life Care Center of Richland 44 Goethals Drive, Richland, WA 99352
Providence Marianwood 3725 Providence Point Drive Southeast, Issaquah, WA 98029
Forks Community Hospital, Ltcu 530 Bogachiel Way, Forks, WA 98331
Life Care Center of The San Juan Islands 660 Spring Street, Friday Harbor, WA 98250