Spokane Health & Rehab: Immediate Jeopardy Fire Risk - WA
Federal inspectors who arrived in April rated what they found as immediate jeopardy, the most serious level of harm designation available under federal nursing home oversight.
The resident at the center of the December incident, identified in inspection records as Resident 461, had a history staff described openly. The Assistant Director of Nursing told inspectors the resident smoked, had been offered a nicotine patch, refused it, and chose to smoke. She said the resident "was not safe to smoke independently" and was "self directed and did what they wanted to do." Another staff member, identified as Staff G, told inspectors Resident 461 was "a challenging resident" who would ignore staff when asked to do things.
Before the fire alarm, on December 29, Resident 461 had already smoked in their bathroom once. That incident also resulted in one-to-one monitoring. It was the second time the facility had responded to the same resident, with the same intervention, for the same behavior.
The problems extended beyond Resident 461.
Resident 86 was admitted to the facility in November 2024 with diagnoses that included weakness and severe cognitive impairment. Hospital records sent to the facility at the time of admission documented that the resident smoked cigarettes every day. A safety assessment completed less than a week after admission said the resident did not use tobacco products and that the facility did not allow resident smoking.
Those two things could not both be true.
A care plan drawn up the following week acknowledged the reality: Resident 86 preferred to smoke cigarettes daily. Staff were instructed to educate the resident about smoking risks, tell them about cessation aids, and remind them the facility was non-smoking.
When inspectors interviewed Resident 86 in April, five months after admission, the resident said they used to smoke but hadn't in a while. They also said staff had never spoken to them about smoking. They said they didn't know the building was non-smoking.
The facility's own administrator, Staff A, told inspectors during a follow-up interview on April 24 that they expected staff to accurately assess residents for tobacco use and implement smoking safety interventions as needed. That expectation, the inspection record makes clear, had not been met for either resident.
What the inspection captured was a gap between what the facility documented and what it actually did. Resident 86's admission paperwork contradicted itself within days. The care plan that followed acknowledged daily smoking but led to no conversation the resident could recall five months later. Resident 461 received the same monitoring response twice for the same unsafe behavior, and when the fire alarm sounded, no one could determine what had actually happened.
The immediate jeopardy finding covered many residents, not just the two named in the report. Inspectors cross-referenced the smoking failures with additional deficiencies in resident rights, admission documentation, and care planning.
Resident 86, severely cognitively impaired and relying on staff to explain the rules of the building they now lived in, sat for months without that conversation ever taking place. When inspectors finally asked, the resident said no one had said a word.
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.
Corrections: We strive for accuracy in everything we publish. If you believe any fact in this article is incorrect, please contact us with details, and we will review and correct it promptly.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 31, 2026 · Our methodology
SPOKANE HEALTH & REHABILITATION in SPOKANE, WA was cited for immediate jeopardy violations during a health inspection on April 24, 2025.
The resident at the center of the December incident, identified in inspection records as Resident 461, had a history staff described openly.
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.