Critical Findings
1
Washington Odd Fellows Home: Fac Risk 11.78 — Highest in VMFH System
Virginia Mason Medical Center sends patients to Washington Odd Fellows Home (Walla Walla), which carries a facility-specific risk score of 11.78 — the highest in the entire VMFH post-acute network. Avamere Heritage Rehabilitation of Tacoma (fac risk 9.56 at Virginia Mason) and St. Anthony (8.24) represent the next-highest concerns. Immediate preferred network review required for both facilities.
2
St. Michael: 46.4% of All SNF Volume Flows to a Single Facility
Sante SNF Op Co (Silverdale) receives 420 of St. Michael Medical Center's 906 FFS SNF patients — 46.4% concentration in a single partner. This is the most extreme single-facility dependency in the VMFH system and creates systemic risk if Sante's performance deteriorates. Columbia Lutheran Home carries a fac risk of 7.98 in St. Michael's network, the highest for that hospital. Immediate concentration risk review is warranted.
3
Avalon Care Center Federal Way: Very High Fac Risk at 7 of 8 Hospitals
Avalon Care Center Federal Way appears at 7 of 8 VMFH hospitals with Very High facility risk scores at Virginia Mason (6.22), St. Anthony (5.45), St. Michael (4.33), and St. Francis (4.32). St. Francis is the largest sender (31 patients, 40.5% hospitalization rate). The Bristol Hospice parent network and consistent Very High risk pattern across 7 hospitals warrants immediate system-level preferred network exclusion review.
4
Extreme SNF Concentration Across Multiple Hospitals
St. Francis: 41.9% to Garden Terrace Federal Way (129 patients). St. Anthony: 59.5% in top 2 facilities (Cottesmore 36.2% + Life Care Port Orchard 23.3%). St. Anne: 50.4% in top 2 (Judson Park 25.9% + Wesley Homes 24.5%). St. Elizabeth: 64.5% in top 2. High concentration creates dependency risk, limits quality leverage, and concentrates readmission exposure in a handful of partners.
5
Life Care Center of South Hill: Only SNF Appearing at All 8 Hospitals
Life Care Center of South Hill (Puyallup) is the single most widely-referred SNF in the VMFH system — all 8 hospitals discharge patients there. St. Joseph is the largest sender (68 patients, 10.5%). St. Michael's facility-specific risk score for this SNF is 5.06 (Very High). A system-level preferred network conversation anchored at Life Care South Hill has immediate leverage across the entire VMFH network.
Hospital Portfolio
St. Michael
Silverdale, WA · 248 beds
SNF Patients
906
30d Readmit
16.6%
Opp. Score
59 — Immediate
Virginia Mason
Seattle, WA · 371 beds
SNF Patients
441
30d Readmit
N/A
Opp. Score
54 — Immediate
St. Joseph
Tacoma, WA · 374 beds
SNF Patients
646
30d Readmit
14.6%
Opp. Score
51 — Immediate
St. Francis
Federal Way, WA · 152 beds
SNF Patients
308
30d Readmit
15.6%
Opp. Score
51 — Immediate
St. Anthony
Gig Harbor, WA · 80 beds
SNF Patients
536
30d Readmit
N/A
Opp. Score
50 — Immediate
St. Clare
Lakewood, WA · 106 beds
SNF Patients
234
30d Readmit
15.6%
Opp. Score
45 — Near-Term
St. Elizabeth
Enumclaw, WA · 25 beds
SNF Patients
76
30d Readmit
14.5%
Opp. Score
40 — Near-Term
St. Anne
Burien, WA · 133 beds
SNF Patients
216
30d Readmit
N/A
Opp. Score
34 — Near-Term
Strategic Recommendations
1
Launch System-Level Preferred SNF Network Beginning at St. Michael
St. Michael's 46.4% concentration in Sante SNF Op Co (906 total patients, 44-facility network) makes it the highest-priority engagement. A compact 44-destination footprint is immediately actionable. Start with Sante relationship formalization and introduce Puzzle's monitoring platform to surface Columbia Lutheran (fac risk 7.98) and Bridgeview Care (4.58) as departure candidates.
2
Address Avalon Care Center Federal Way Across All 7 Sending Hospitals
Avalon Federal Way's Very High fac risk at Virginia Mason (6.22), St. Anthony (5.45), and four additional hospitals signals a systemic quality concern. Coordinate a cross-hospital preferred network exclusion conversation through VMFH's post-acute leadership. Puzzle can provide real-time monitoring to quantify readmission risk and inform the decision.
3
Use Life Care Center of South Hill as the System-Wide Network Anchor
With all 8 hospitals sending patients to Life Care South Hill, this facility represents the single highest-leverage relationship in the VMFH network. Formalizing a preferred partnership here — with Puzzle's performance monitoring — creates immediate cross-system visibility and an accountability framework scalable to the other 70+ cross-system SNFs.
4
Reduce the 123-SNF Virginia Mason Footprint to a Monitored Core
Virginia Mason's 123-destination network is the most fragmented in the system and operationally impossible to monitor without infrastructure. Washington Odd Fellows (fac risk 11.78) and Avamere Heritage (9.56) should be immediate exit candidates. Puzzle's preferred network tools can compress this to a curated 20–30 facility list with real-time performance data, reducing both readmission exposure and monitoring burden.
5
Pilot Puzzle Healthcare at St. Michael or St. Joseph as the System Entry Point
St. Michael's above-state readmission rate (16.6%), extreme concentration risk, and compact 44-facility network make it the fastest path to demonstrable ROI. St. Joseph's 14.57% above-state readmission rate (vs. 12.81% WA avg) and 80-destination network provide strong complementary data. A dual-hospital pilot — with Puzzle's preferred network framework, SNF scorecards, and readmission monitoring — positions VMFH for system-wide rollout within 6–12 months.
Hospital Drill-Down
Opportunity Index
Hospital Engagement Priority Ranking
Composite score (0–100) based on volume, utilization vs. WA state avg (18.30%), readmission rate, network fragmentation, concentration risk, and Very High risk facility count.
| Hospital | Location | SNF Patients | SNF Dests | SNF Util % | 30d Readmit | Score | Priority |
|---|---|---|---|---|---|---|---|
| St. Michael Medical Center | Silverdale, WA | 906 | 44 | 16.60% | 16.60% | 59 | Immediate |
| Virginia Mason Medical Center | Seattle, WA | 441 | 123 | — | — | 54 | Immediate |
| St. Joseph Medical Center | Tacoma, WA | 646 | 80 | 16.97% | 14.57% | 51 | Immediate |
| St. Francis Hospital | Federal Way, WA | 308 | 50 | 18.84% | 15.63% | 51 | Immediate |
| St. Anthony Hospital | Gig Harbor, WA | 536 | 41 | — | — | 50 | Immediate |
| St. Clare Hospital | Lakewood, WA | 234 | 43 | 19.45% | 15.63% | 45 | Near-Term |
| St. Elizabeth Hospital | Enumclaw, WA | 76 | 10 | 22.65% | 14.46% | 40 | Near-Term |
| St. Anne Hospital | Burien, WA | 216 | 28 | — | — | 34 | Near-Term |
Scores are relative within the Virginia Mason Franciscan Health system. Higher score = higher engagement priority for Puzzle Healthcare. SNF Util % and 30d Readmit shown where available from Trella Health. WA state SNF utilization avg: 18.30%. WA state 30-day readmission avg: 12.81% (FFS).
Cross-System SNF Analysis
SNFs Appearing at 3+ VMFH Hospitals
These 11 facilities represent system-level preferred network opportunities or risk concerns. 70 SNFs total appear at 3+ hospitals across the VMFH network. Sorted by priority, then hospital count.
| SNF Facility | # Hospitals | Hosp Rate | 30d Readmit | Max Fac Risk | Priority |
|---|---|---|---|---|---|
| Life Care Center of South Hill | 8 | 34.6% | 12.9% | 5.06 | High |
| Sante SNF Op Co, LLC | 5 | 31.1% | 11.4% | 3.02 | High |
| Cottesmore of Life Care | 5 | 43.4% | 15.0% | 3.55 | High |
| Life Care Center of Port Orchard | 5 | 35.0% | 12.3% | 3.99 | High |
| Garden Terrace Healthcare Center of Federal Way | 6 | 50.9% | 12.8% | 3.43 | High |
| Avamere Rehabilitation at Ridgemont | 5 | 44.8% | 15.3% | 3.82 | Near-Term |
| Martha and Mary Health Services | 5 | 18.0% | 9.4% | 2.96 | Near-Term |
| Enumclaw Health & Rehabilitation Center | 7 | ins | 12.0% | 4.36 | Near-Term |
| Judson Park Health Center | 4 | 41.0% | 8.6% | 3.27 | Near-Term |
| Avalon Care Center - Federal Way LLC | 7 | 40.5% | 13.8% | 6.22 | Immediate |
| Hallmark Manor | 4 | 45.2% | 16.7% | 5.42 | Immediate |
Hospitalization rate shown from the hospital with highest available data for each SNF. Max fac risk = highest facility-specific risk score across all sending hospitals. “Immediate” = system-level review required. “Near-Term” = preferred network discussion warranted. “High” = strong preferred network candidate. Data: Trella Health Marketscape, Q4 2023–Q3 2025 (FFS).