Cycle 1
Health 2025-05-27 · Fire 2025-05-27
8 health deficiencies
Top issue: Pharmacy Service (2 deficiencies)
3 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (3 deficiencies)
Lynden, WA
Christian Health Care Center
5-star overall rating with 4-star inspections with 8 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
855 Aaron Drive, Lynden, WA
(360) 354-4434
Overall
5 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
122
Certified beds
Average residents
98
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1992-01-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
1.08
Registered nurse staffing · state 0.88 · national 0.68
LPN hours / resident day
0.68
Licensed practical nurse staffing · state 0.81 · national 0.87
Aide hours / resident day
2.53
Nurse aide staffing · state 2.69 · national 2.35
Total nurse hours
4.30
All reported nurse hours · state 4.39 · national 3.89
Licensed hours
1.76
RN + LPN hours · state 1.70 · national 1.54
Weekend hours
3.83
Weekend nurse staffing · state 3.79 · national 3.43
Weekend RN hours
0.90
Weekend registered nurse coverage · state 0.63 · national 0.47
Physical therapist
0.05
Reported PT staffing · state 0.09 · national 0.07
Adjusted RN hours
0.90
CMS adjusted RN staffing hours
Adjusted total hours
3.57
CMS adjusted total nurse staffing hours
Case-mix index
1.65
Higher values indicate more complex resident acuity
RN turnover
33%
Annual RN turnover · state 47% · national 45%
Total nurse turnover
38%
Annual nurse turnover · state 47% · national 46%
SNF VBP
Value-based purchasing
Program rank
3,625
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
43.42
Composite VBP score used to determine payment impact.
Payment multiplier
0.9964
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0.79
Baseline 17.94% · Performance 21.07% · Measure score 0.79 · Achievement 0.79 · Improvement 0
Healthcare-associated infections
6.57
Baseline 5.28% · Performance 5.87% · Measure score 6.57 · Achievement 6.57 · Improvement 0
Total nurse turnover
7.03
Baseline 44.25% · Performance 34.96% · Measure score 7.03 · Achievement 7.03 · Improvement 4.29
Adjusted total nurse staffing
2.98
Baseline 3.53 hours · Performance 3.93 hours · Measure score 2.98 · Achievement 2.98 · Improvement 1.27
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 8.97% |
10.72%
1.8 pts better
|
No Different than the National Rate · Eligible stays 174 · Observed rate 5.75% · Lower 95% interval 6.48% |
| Discharge to community | 46.48% |
50.57%
4.1 pts worse
|
No Different than the National Rate · Eligible stays 167 · Observed rate 44.31% · Lower 95% interval 40.7% |
| Medicare spending per beneficiary | 0.74 |
1.02
0.3 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 126 · Denominator 126 |
| Falls with major injury | 0.79% |
0.77%
About the same
|
Numerator 1 · Denominator 126 |
| Discharge self-care score | 44.09% |
53.69%
9.6 pts worse
|
Numerator 41 · Denominator 93 |
| Discharge mobility score | 45.16% |
50.94%
5.8 pts worse
|
Numerator 42 · Denominator 93 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 126 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 5.87% |
7.12%
1.2 pts better
|
No Different than the National Rate · Eligible stays 110 · Observed rate 2.73% · Lower 95% interval 3.53% |
| Staff COVID-19 vaccination coverage | 15.31% |
8.2%
7.1 pts better
|
Numerator 45 · Denominator 294 |
| Staff flu vaccination coverage | 29.56% |
42%
12.4 pts worse
|
Numerator 81 · Denominator 274 |
| Discharge function score | 41.94% |
56.45%
14.5 pts worse
|
Numerator 39 · Denominator 93 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 17 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 98.57% |
96.28%
2.3 pts better
|
Numerator 69 · Denominator 70 |
| Resident COVID-19 vaccinations up to date | 32.79% |
25.2%
7.6 pts better
|
Numerator 20 · Denominator 61 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.5 |
1.4
0.9 pts better
|
1.9
1.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.5 · Observed 0.5 · Expected 1.8 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.5 |
1.5
1 pts better
|
1.8
1.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.5 · Observed 0.5 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.5% |
96.0%
2.5 pts better
|
93.4%
5.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 98.9% · Q3 96.4% · Q4 98.7% · 4Q avg 98.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
93.8%
6.2 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 3.2% |
2.6%
0.6 pts worse
|
3.3%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.2% · Q2 3.4% · Q3 3.6% · Q4 3.8% · 4Q avg 3.2% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 51.7% |
16.3%
35.4 pts worse
|
11.4%
40.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 47.2% · Q2 52.9% · Q3 50.6% · Q4 56.4% · 4Q avg 51.7% |
| Percentage of long-stay residents who lose too much weight | 2.5% |
5.8%
3.3 pts better
|
5.4%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 4.1% · Q3 2.9% · Q4 1.6% · 4Q avg 2.5% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 11.1% |
12.1%
1 pts better
|
19.6%
8.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.1% · Q2 13.7% · Q3 10.0% · Q4 9.4% · 4Q avg 11.1% |
| Percentage of long-stay residents who received an antipsychotic medication | 3.2% |
15.9%
12.7 pts better
|
16.7%
13.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 4.2% · Q3 3.5% · Q4 0.0% · 4Q avg 3.2% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 16.6% |
20.0%
3.4 pts better
|
16.3%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 26.4% · Q2 12.5% · Q3 11.5% · Q4 15.3% · 4Q avg 16.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 14.8% |
15.8%
1 pts better
|
14.9%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 27.3% · Q2 13.0% · Q3 10.3% · Q4 8.3% · 4Q avg 14.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
1.2%
1.2 pts better
|
1.0%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.6% |
1.7%
1.1 pts better
|
1.7%
1.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.1% · Q2 0.0% · Q3 1.2% · Q4 0.0% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 36.8% |
23.5%
13.3 pts worse
|
19.8%
17 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 31.0% · Q2 35.1% · Q3 38.7% · Q4 43.0% · 4Q avg 36.8% |
| Percentage of long-stay residents with pressure ulcers | 0.1% |
4.7%
4.6 pts better
|
5.1%
5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.6% · 4Q avg 0.1% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 85.1% |
87.7%
2.6 pts worse
|
81.7%
3.4 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 91.8% · Q2 88.8% · Q3 82.6% · Q4 78.0% · 4Q avg 85.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 11.2% |
13.2%
2 pts better
|
12.0%
0.8 pts better
|
Short Stay · 20240701-20250630 · Adjusted 11.2% · Observed 9.9% · Expected 9.8% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.6% |
1.4%
0.8 pts better
|
1.6%
1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 1.1% · Q3 0.0% · Q4 0.0% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 97.5% |
82.0%
15.5 pts better
|
79.7%
17.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 97.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 32.3% |
19.9%
12.4 pts worse
|
23.9%
8.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 32.3% · Observed 25.3% · Expected 18.7% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-08-21 · Fire 2024-08-21
2 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-04-13 · Fire 2023-04-13
1 health deficiencies
Top issue: Infection Control (1 deficiency)
5 fire-safety deficiencies
Top issue: Emergency Preparedness (2 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-05-27
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2025-06-20
F · Potential for more than minimal harm
2025-05-27
K921 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure that testing and maintenance of electrical equipment is performed.
Corrected 2025-06-20
D · Potential for more than minimal harm
2025-05-27
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2025-06-20
F · Potential for more than minimal harm
2023-04-13
E36 · Emergency Preparedness Deficiencies
Fire Safety
Establish emergency prep training and testing.
Corrected 2023-05-01
E · Potential for more than minimal harm
2023-04-13
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2023-05-01
E · Potential for more than minimal harm
2023-04-13
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-05-01
D · Potential for more than minimal harm
2023-04-13
E31 · Emergency Preparedness Deficiencies
Fire Safety
Provide emergency officials' contact information.
Corrected 2023-05-01
D · Potential for more than minimal harm
2023-04-13
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-05-01
Inspection history
Recent health citations
G · Actual harm
2025-05-27
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-06-20
E · Potential for more than minimal harm
2025-05-27
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2025-06-20
E · Potential for more than minimal harm
2025-05-27
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2025-07-09
E · Potential for more than minimal harm
2025-05-27
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-07-09
E · Potential for more than minimal harm
2025-05-27
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2025-07-09
E · Potential for more than minimal harm
2025-05-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-07-09
D · Potential for more than minimal harm
2025-05-27
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-07-09
D · Potential for more than minimal harm
2025-05-27
F757 · Pharmacy Service Deficiencies
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2025-06-20
D · Potential for more than minimal harm
2024-08-21
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2024-09-16
D · Potential for more than minimal harm
2024-08-21
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2024-09-16
D · Potential for more than minimal harm
2023-04-13
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-05-08
Penalties and ownership
What sits behind the stars
Ownership
Aupperlee, Jeanne
Corporate Officer · Individual
Buys, Vincent
Corporate Officer · Individual
De Young, Kevin
Corporate Director · Individual
Gibson, Emily
Corporate Officer · Individual
Lee, Angie
Contracted Managing Employee · Individual
Lewis, Heather
W-2 Managing Employee · Individual
Myers, Tonja
Operational/Managerial Control · Individual
Myers, Tonja
Corporate Director · Individual
Myers, Tonja
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
North Cascades Health and Rehabilitation
Bellingham, WA
2-star overall rating with 1-star inspections with $347,043 in total fines with 25 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
#2
Alderwood Park Health And Rehab Of Cascadia
Bellingham, WA
3-star overall rating with 2-star inspections with $52,574 in total fines with 12 recent health deficiencies with 13 fire-safety deficiencies in the latest cycle
#3
Avalon Healthcare Bellingham
Bellingham, WA
4-star overall rating with 3-star inspections with $106,024 in total fines with 11 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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