Spokane Health & Rehabilitation: Staffing Failures Cited - WA
The administrator's response, when federal inspectors raised the issue two days later: "I am not short staffed."
The April 2025 inspection, completed on April 24, documented what staff and inspectors described as a persistent and acknowledged shortage of nursing assistants on the facility's North 100 long-term care hall, a unit that housed at least nine residents identified in the report. The staffing coordinator admitted the facility relied on agency workers seven days a week, had a high staff turnover rate, and had received repeated complaints from residents about call lights going unanswered and changes not happening on time. The administrator classified those resident complaints as allegations of neglect, then said the facility was not short-staffed.
The inspection was conducted over three days, from April 22 through April 24. What inspectors found on the first morning set the tone for everything that followed.
At 9:32 AM on April 22, an inspector watched a nursing assistant identified in the report as Staff KK approach several colleagues on the floor and ask for help changing a resident. Nobody helped. Staff W, another nursing assistant, told Staff KK to ask a manager instead, because Staff W needed to respond to a different resident who had already called for help. At 9:47 AM, Staff KK found Staff LL, a registered nurse, and asked again. Staff LL said, "I am sorry, I can't help you, I am running way behind," then asked Staff KK to notify her once the change was done because the resident needed cream applied. Staff KK's reply: "That is what I have been trying to do. I have been trying to get help."
Two minutes later, at 9:49 AM, Staff KK went back to the resident's room and told them she would do it alone.
Staff W told inspectors the facility was short-staffed most of the time. On the North 100 hall, she said, nursing assistants typically cared for about 15 residents each. That morning, the unit had four nursing assistants. Staff W said that was not enough, that the unit ran heavy care, and that it was hard to get things done.
The staffing coordinator, identified as Staff N, explained to inspectors on April 23 how the facility decided how many staff to schedule. The tool was a spreadsheet, she said, built around census — the number of residents in the building on a given day. It did not account for acuity, meaning it did not factor in how sick or dependent those residents actually were. Staff N said if acuity increased, the facility would pull staff from other units and reassign them. She described the North 100 hall as the easier unit, more consistent, because those residents were long-term care. The South hall, she said, was the more acute unit, where newly admitted residents arrived and were typically more ill.
She was asked what would happen if census increased. She said the facility would have to schedule more agency staff because it did not have enough of its own. She confirmed agency staffing was used seven days a week, for both nursing assistants and nurses. She confirmed the facility had a high staff turnover rate. And she confirmed that staff had raised concerns: not enough staff, call lights waiting too long, residents not changed on time.
The administrator, identified as Staff A, had a copy of the same spreadsheet. She described it as a quick and fast tool, based on census. She did not provide inspectors a copy when they requested one.
In a follow-up interview the next morning, the administrator said the facility reassessed staffing every shift and tried to balance staffing, census, and acuity. She said staff brought concerns to her when they had them. She said resident complaints about call light wait times were logged as allegations of neglect. She acknowledged the facility had seen an increased number of abuse and neglect allegations. Then she said: "I am not short staffed."
That statement sits at the center of what the inspection documented. The staffing coordinator had already told inspectors the facility used agency workers every single day of the week because it lacked enough permanent staff. Staff had told inspectors directly that four nursing assistants on the North 100 hall was not enough. An inspector had watched, in real time, a nursing assistant spend seventeen minutes unable to find a single person willing or able to stop what they were doing to help change a resident. The registered nurse who turned Staff KK away did not do so out of indifference — she was running behind herself. That is what a short-staffed unit looks like from the inside.
The facility's own staffing tool was built without accounting for how much care residents actually needed. The staffing coordinator acknowledged that. She said if acuity increased, the facility would adjust, would pull from other units, would bring in more agency workers. But the North 100 hall, she had explained, was considered the easier unit, which meant it was likely to receive fewer of those adjustments when resources were stretched. The residents on that hall, many of them long-term care patients who had lived there for months or years, were in the unit that the facility's own logic treated as lower priority.
Nine residents were identified in the inspection report as living on the North 100 hall at the time of the April 19 census: Residents 15, 16, 22, 46, 61, 63, 64, 65, and 85. The report does not describe what happened to each of them individually. It does not need to. The pattern the inspection documented, the staffing coordinator's admissions, the real-time observation of Staff KK walking from person to person and being turned away, the registered nurse apologizing and saying she was already running behind, the resident being told they would be changed alone, is enough to understand what daily life on that hall looked like.
The administrator's classification of resident complaints as neglect allegations is worth pausing on. Neglect, in the context of a nursing home, is a serious finding. It triggers investigation, documentation, reporting. If the administrator was logging call light complaints as neglect allegations and acknowledged the facility had seen an increased number of such allegations, that is not evidence of a well-staffed facility catching rare problems. That is evidence of a pattern the facility's own leadership had named and counted and continued to classify as exceptional rather than structural.
The staffing coordinator said the facility had a high turnover rate and needed more staff. She said that plainly, to an inspector, under oath. The administrator said the facility was not short-staffed. One of those two things is more consistent with what the inspector watched happen at 9:32 on a Tuesday morning, when a nursing assistant started asking for help and was still asking seventeen minutes later, and the only answer she got from the last person she found was an apology and a request to send word when the job was finally done.
The resident in that room waited.
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.
The administrator classified those resident complaints as allegations of neglect, then said the facility was not short-staffed.
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.