Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

COLVILLE TRIBAL CONVALESCENT C

NESPELEM, WA · 44 certified beds · Last Life Safety survey April 3, 2025

CMS Certification Number 505412 · first certified January 1992

Ownership

Independently operated (no chain recorded by CMS) · Government - Federal

No change of ownership on CMS record since January 1, 2016, when the records begin.

37
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
12
Tags cited more than once
Across separate surveys
20
Inspection & testing records
Of the citations on file

Position within WA

37 citations — more than 66% of the 193 certified nursing homes in WA. Compared within WA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 11 citations; the earlier surveys in the window averaged 13. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (March 2026 to June 2026), and past the point by which nine in ten WA facilities have been surveyed. This facility’s last Life Safety survey was April 2025. Facilities in WA are typically surveyed 12–15 months after the last one (median 13), measured over 320 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

8 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

6 of the 37 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

3 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 37 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

How that compares

Citations on file over three years

Compared with the median facility in WA, and nationally. Surveyors differ markedly between states, so the WA figure is the meaningful one.

This facility37WA median31National median11
Citations on file over three years, compared
MeasureCitations
This facility37
Median facility in WA31
Median facility nationally11

Survey history

Citations at each Life Safety survey
182023-0382024-04112025-04
Citations at each Life Safety survey
Survey dateCitations
March 3, 202318
April 30, 20248
April 3, 202511

Most-cited tags

Most-cited tags at this facility
K-03243K-03533K-09182K-07612K-05112K-03742K-03452K-09212
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0324Provide properly protected cooking facilities.32025-04-03
K-0353Inspect, test, and maintain automatic sprinkler systems.32025-04-03
K-0918Have generator or other power source capable of supplying service within 10 seconds.22025-04-03
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.22025-04-03
K-0511Have properly installed electrical wiring and gas equipment.22025-04-03
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.22024-04-30
K-0345Have approved installation, maintenance and testing program for fire alarm systems.22025-04-03
K-0921Ensure that testing and maintenance of electrical equipment is performed.22025-04-03

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 15
  • Gas, Vacuum, and Electrical Systems Deficiencies 6
  • Emergency Preparedness Deficiencies 6
  • Miscellaneous Deficiencies 4
  • Other 6
Citations by CMS category
CategoryCitations
Smoke Deficiencies15
Gas, Vacuum, and Electrical Systems Deficiencies6
Emergency Preparedness Deficiencies6
Miscellaneous Deficiencies4
Services Deficiencies3
Egress Deficiencies2
Construction Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

April 3, 2025 — 11 citations

Citations issued on April 3, 2025
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (May 1, 2025)
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (May 1, 2025)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (May 1, 2025)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (May 26, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 1, 2025)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (May 1, 2025)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (May 1, 2025)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (May 1, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (May 26, 2025)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (May 1, 2025)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (May 26, 2025)

April 30, 2024 — 8 citations

Citations issued on April 30, 2024
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (May 30, 2024)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (May 30, 2024)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (May 30, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (May 30, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 30, 2024)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (May 30, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (May 30, 2024)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (May 30, 2024)

March 3, 2023 — 18 citations

Citations issued on March 3, 2023
TagWhat the surveyor checksStatus
E-0024Establish policies and procedures for volunteers.Deficient, Provider has date of correction (April 4, 2023)
E-0030List the names and contact information of those in the facility.Deficient, Provider has date of correction (April 4, 2023)
E-0037Establish staff and initial training requirements.Deficient, Provider has date of correction (April 4, 2023)
K-0100Meet other general requirements.Deficient, Provider has date of correction (April 4, 2023)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (April 4, 2023)
K-0324Provide properly protected cooking facilities.Waiver has been granted (April 4, 2023)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (April 4, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 4, 2023)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (April 4, 2023)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (April 4, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (April 4, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Waiver has been granted (April 4, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 4, 2023)
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (April 4, 2023)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (April 4, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Waiver has been granted (April 4, 2023)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (April 4, 2023)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (April 4, 2023)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.