1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Fir Lane Health & Rehabilitation Center, operated by Caldera Care, is a leading provider of long-term skilled nursing care and short-term rehabilitation solutions, offering a full continuum of services and care focused around each individual in today’s ever-changing health care environment. The center, which has served Mason and the surrounding communities for over 25 years, is minutes away from historic downtown Shelton and conveniently located close to Mason General Hospital. Fir Lane Health & Rehabilitation Center is Medicare and Medicaid certified, ensuring that it meets the highest standards of care.
The 135-bed center offers a range of services, including physical therapy, speech therapy, nutritional support, occupational therapy, and wellness-focused activities. These services are designed to help residents regain their strength, mobility, and independence after an illness, injury, or surgery, while also providing ongoing care for those with chronic health conditions or disabilities. Fir Lane Health & Rehabilitation Center’s experienced staff deliver quality care while giving residents a serene, safe, and comfortable place to enjoy healing and rest.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing hours
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Hours per resident per day vs Washington averages
Total nursing care
This home is ranked 21st out of 61 homes in Washington for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 23m
4% above state avg
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
3 of 6 metrics below state avg
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Washington average 7.8
Last Health inspection on Aug 2025
Washington average 48.9
Washington average 6.92
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
52 of 79 citations resulted from standard inspections; 26 of 79 resulted from complaint investigations; and 1 of 79 came from combined inspections (standard and complaint).
233% worse than Washington averageWashington average: 0.3
76% worse than Washington averageWashington average: 1.7
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
71% more staff per resident than Washington average
0% compared with Washington average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 12 RN Staff are full-time employees. No contractors work on this role.
12
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.1 hoursAssists with medical care and medications.
39 total: 16 full-time employees and 23 contractors.
39
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hoursHelps with daily care and mobility.
135 total: 43 full-time employees and 92 contractors.
135
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
7,213 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 43 | 92 | 135 | 18,979 | 92 | 100% | 8.2 |
| Licensed Practical Nurse | 16 | 23 | 39 | 5,947 | 92 | 100% | 9.7 |
| Registered Nurse | 12 | 0 | 12 | 3,635 | 91 | 99% | 10.1 |
| Nurse Aide in Training | 13 | 0 | 13 | 3,163 | 91 | 99% | 7.8 |
| RN Director of Nursing | 4 | 0 | 4 | 984 | 75 | 82% | 8.2 |
| Other Dietary Services Staff | 2 | 0 | 2 | 931 | 92 | 100% | 7.2 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 724 | 63 | 68% | 8 |
| Speech Language Pathologist | 5 | 0 | 5 | 583 | 80 | 87% | 6 |
| Administrator | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Mental Health Service Worker | 1 | 0 | 1 | 476 | 67 | 73% | 7.1 |
| Nurse Practitioner | 4 | 0 | 4 | 464 | 52 | 57% | 8 |
| Dietitian | 2 | 0 | 2 | 450 | 61 | 66% | 7.2 |
| Dental Services Staff | 2 | 0 | 2 | 315 | 46 | 50% | 6.8 |
| Respiratory Therapy Technician | 4 | 0 | 4 | 295 | 43 | 47% | 6.4 |
| Physical Therapy Aide | 3 | 1 | 4 | 222 | 36 | 39% | 6.2 |
| Physical Therapy Assistant | 2 | 0 | 2 | 206 | 29 | 32% | 6.2 |
| Occupational Therapy Aide | 2 | 1 | 3 | 144 | 38 | 41% | 3.8 |
| Qualified Social Worker | 2 | 0 | 2 | 64 | 27 | 29% | 2.4 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 40 | 7 | 8% | 5.7 |
| Medical Director | 0 | 2 | 2 | 32 | 20 | 22% | 1.6 |
Includes penalties issued in 2024-2025
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
70% higher than Washington averageWashington average: $82K
62% more fines than Washington averageWashington average: 1.8
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Washington averageWashington average: 0.3
Penalties are imposed by CMS for violations of federal nursing home regulations.
2 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Feb 21, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 7, 2024Last updated: Jan 2026
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
11.9
19% worse than Washington averageWashington average: 10.0
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
21.0
In line with Washington averageWashington average: 20.9
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
17.7%
8% worse than Washington averageWashington average: 16.4%
Percent of long-stay residents whose ability to move independently worsened
18.8%
14% better than Washington averageWashington average: 21.8%
Percent of low risk long-stay residents who lose control of their bowels or bladder
26.5%
9% worse than Washington averageWashington average: 24.3%
Percent of long-stay residents experiencing one or more falls with major injury
2.6%
In line with Washington averageWashington average: 2.6%
Percent of long-stay high risk residents with pressure ulcers
12.7%
158% worse than Washington averageWashington average: 4.9%
Percent of long-stay residents with a urinary tract infection
1.5%
12% better than Washington averageWashington average: 1.7%
Percent of long-stay residents who lose too much weight
7.8%
34% worse than Washington averageWashington average: 5.8%
Percent of long-stay residents who have depressive symptoms
7.4%
54% better than Washington averageWashington average: 16.2%
Percent of long-stay residents who received an antipsychotic medication
36.7%
153% worse than Washington averageWashington average: 14.5%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
92.1%
In line with Washington averageWashington average: 96.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
92.2%
In line with Washington averageWashington average: 93.8%
Number of hospitalizations per 1,000 long-stay resident days.
0.68
51% better than Washington averageWashington average: 1.38
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.74
15% worse than Washington averageWashington average: 1.51
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
68.7%
22% worse than Washington averageWashington average: 88.1%
Percent of short-stay residents who newly received an antipsychotic medication
2.7%
91% worse than Washington averageWashington average: 1.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
51.5%
37% worse than Washington averageWashington average: 82.0%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
24.8%
25% worse than Washington averageWashington average: 19.9%
Percentage of short-stay residents who had an outpatient emergency department visit.
15.3%
16% worse than Washington averageWashington average: 13.2%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Washington averageWashington average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
66.1%
23% better than Washington averageWashington average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
32.9%
35% worse than Washington averageWashington average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
52% of new residents, usually for short-term rehab.
36% of new residents, often for short stays.
12% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
76Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Fir Lane Health & Rehabilitation Center from 2011–2023, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 12/2023.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #46 / 51Payroll costs — State benchmarkedThis home is ranked 46th out of 51 homes in Washington. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Washington average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Washington that report data for that category. Facilities without available data are excluded from the ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #49 / 51Payroll % of net patient revenue — State benchmarkedThis home is ranked 49th out of 51 homes in Washington. Shows payroll as a percentage of net patient revenue versus the Washington average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Washington that report data for that category. Facilities without available data are excluded from the ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
No pets allowed
Building Type: Single-story
Fitness and Recreation
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (52% of admissions), and a typical Medicare stay runs around 26 days.
Coverage residents most often arrive under.
Coverage residents most often leave under.
1.2 miles from city center
Estimated distance in miles from Shelton's city center to Fir Lane Health & Rehabilitation Center's address, calculated via Google Maps.
— 0.38 miles to nearest hospital (Mason Health - Mason General Hospital)
Add your location
Info below is compiled from CMS reports & the WA Dept. of Social & Health Services (DSHS), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest to lowest based on our ranking methodology.
| Fir Lane Health & Rehabilitation Center | NH MC SNF | Shelton (Christmas Village) | 135
Facility
135
WA AVG
81
Rank
#27 / 356 |
63.1%
Facility
63.1%
WA AVG
73.6
Rank
#217 / 283 | -14% | 4.39
Facility
4.39
WA AVG
4.22
Rank
#21 / 61 | -65% | +4% | $121.5k
Facility
$121.5k
WA AVG
$87.7k
Rank
#53 / 61 | 79
Facility
79
WA AVG
48.9
Rank
#52 / 61 | 4.9
Facility
4.9
WA AVG
6.9
Rank
#20 / 61 | 4 | 85 | A+ |
23
Facility
23
WA AVG
51
Rank
#511 / 618 | - | $11.4MFiscal year ending 12/2023
Facility
$11.4MFiscal year ending 12/2023
WA AVG
$15.9M
Rank
#32 / 51 | $4.4MFiscal year ending 12/2023
Facility
$4.4MFiscal year ending 12/2023
WA AVG
$9.2M
Rank
#46 / 51 | 38.7%Fiscal year ending 12/2023
Facility
38.7%Fiscal year ending 12/2023
WA AVG
62.6%
Rank
#49 / 51 | 505230 | ||||
| Bremerton Trails Post Acute | NH SNF | Bremerton | 125
Facility
125
WA AVG
81
Rank
#37 / 356 |
83.4%
Facility
83.4%
WA AVG
73.6
Rank
#90 / 283 | +13% | 4.31
Facility
4.31
WA AVG
4.22
Rank
#24 / 61 | -28% | +2% | $232.3k
Facility
$232.3k
WA AVG
$87.7k
Rank
#58 / 61 | 103
Facility
103
WA AVG
48.9
Rank
#58 / 61 | 4.5
Facility
4.5
WA AVG
6.9
Rank
#13 / 61 | 4 | 104 | - |
62
Facility
62
WA AVG
51
Rank
#224 / 618 | - | $13.2MFiscal year ending 12/2023
Facility
$13.2MFiscal year ending 12/2023
WA AVG
$15.9M
Rank
#25 / 51 | $6.3MFiscal year ending 12/2023
Facility
$6.3MFiscal year ending 12/2023
WA AVG
$9.2M
Rank
#35 / 51 | 47.7%Fiscal year ending 12/2023
Facility
47.7%Fiscal year ending 12/2023
WA AVG
62.6%
Rank
#44 / 51 | 505123 |
Fir Lane Health & Rehabilitation Center is located in Shelton, Washington State.
Here are the financial assistance programs available to residents in Washington State.
Fir Lane Health & Rehabilitation Center is in the Christmas Village neighborhood of Shelton.
Fir Lane Health & Rehabilitation Center has a walk score of 23. Car-dependent. Most errands require a car, with limited nearby walkable options.
Fir Lane Health & Rehabilitation Center's occupancy is 60.0%.
Fir Lane Health & Rehabilitation Center has been operating for approximately 9 years, based on available licensing and registration records.
No, Fir Lane Health & Rehabilitation Center has a no-pet policy.
Fir Lane Health & Rehabilitation Center is registered as a for-profit in WA.
Fir Lane Health & Rehabilitation Center has had 79 reported deficiencies since 2023 according to records from WA Dept. of Social and Health Services (DSHS).
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