In Washington state, for instance, a state inspector documented staffing levels at the Arcadia Healthcare — University Place on Jan. 27, 2020. For 110 residents, there were four direct-care nurses on duty during the day shift, a ratio of one nurse assistant to 27 residents, according to the report. That day, multiple residents received their insulin hours late. The inspection report cited other examples of allegedly deficient care, including untreated pain and poor wound care.”