Spokane Health & Rehab: Antibiotic Oversight Failures - WA
That assumption, inspectors found, left dozens of residents without any documented review of whether the antibiotics they were taking were actually warranted.
The deficiency, cited following an April 24 inspection, centered on the facility's Antibiotic Stewardship Program, a structured process designed to ensure antibiotics are prescribed only when they meet a recognized threshold of need. The standard the facility had committed to using is called McGeer Criteria, a set of clinical definitions that help distinguish infections requiring antibiotics from conditions that don't. The facility's own policy, written in August 2023, named antibiotic stewardship as a core element of its infection prevention program.
For three months, inspectors found, that program was not being applied to residents arriving from hospitals or coming in already on antibiotics prescribed by outside providers.
The numbers, drawn from the facility's own monthly surveillance logs, were stark. In January 2025, 28 residents identified with community-acquired infections received antibiotics. For eight of them, the log left blank the question asking whether McGeer's minimum criteria had been met. In February, nine of 24 residents had that same question unanswered. One resident's log showed an outright "No," meaning the criteria were not met. Four others were marked not applicable.
March was worse. Thirty-five residents received antibiotics that month. For 31 of them, the question about McGeer criteria went unanswered. One resident was marked "No." Two were marked not applicable. That left only one resident in March whose antibiotic use was affirmatively documented as meeting the facility's own standard.
Staff D, the facility's infection preventionist, reviewed the logs alongside inspectors on the morning of April 21. She confirmed what the records showed. The antibiotic stewardship process, she acknowledged, had not been applied to new admissions or to residents whose antibiotics had been prescribed by community providers.
Her reasoning: "I am under the impression the hospital ensures McGeer is being followed on their end."
No further information was provided.
The problem with that reasoning is what antibiotic stewardship programs exist to address. When a resident arrives from a hospital or a community setting already on an antibiotic, the prescribing decisions were made in a different clinical environment, for a different clinical moment. A nursing home's stewardship program is meant to evaluate whether continuing that antibiotic still makes sense, whether the original criteria were documented, and whether the course of treatment remains appropriate as the resident's condition evolves in a new setting. Outsourcing that review to whoever prescribed the drug in the first place is not stewardship. It is the absence of it.
The consequence inspectors flagged was the heightened risk of multi-drug-resistant organisms, pathogens that have developed resistance to multiple antibiotics precisely because of overuse and inappropriate use. Residents in nursing homes are already among the most vulnerable to these infections, and facilities that do not actively track and question antibiotic use contribute to conditions in which resistant organisms can take hold and spread.
Inspectors rated the harm level as minimal or potential for actual harm, and noted the violation affected some residents. Across the three months reviewed, 87 residents were identified with community-acquired infections and received antibiotics. For the vast majority of them, there is no documented answer to the most basic question the program was designed to ask.
The facility's policy was in place. The surveillance logs had the question printed on them. The infection preventionist was aware of the program. What was missing was the work of actually applying it, month after month, for residents who arrived already carrying prescriptions from somewhere else.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Spokane Health & Rehabilitation from 2025-04-24 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
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Last verified: October 29, 2026 · Our methodology
SPOKANE HEALTH & REHABILITATION in SPOKANE, WA was cited for violations during a health inspection on April 24, 2025.
That assumption, inspectors found, left dozens of residents without any documented review of whether the antibiotics they were taking were actually warranted.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.