Spokane Valley Health: Nurse Ran Facility Without Valid WA License
The director of nursing, identified in inspection records as Staff A, held a multistate compact RN license that allowed her to practice across participating states with a single credential. That license expired. Ten days later, she obtained a temporary RN license, but it was issued by Idaho, not Washington. She believed the temporary license carried the same multistate authority as her previous one.
It did not.
A staff member from the Idaho Department of Professional Licensing confirmed to inspectors that a temporary Idaho RN license grants authority to practice in Idaho only. The Washington State Board of Nursing was equally direct: to work as a registered nurse in Washington, an out-of-state nurse must hold either a permanent out-of-state license obtained through Washington's endorsement process, or a permanent multistate compact license. A temporary license from another state, the board told inspectors, does not qualify. The board also noted that multistate licensure is tied to a nurse's state of residence, and that the state on a nurse's driver's license must match the state on their RN license.
Staff A told inspectors she had been informed when she received the temporary license that it functioned the same way her previous license had, carrying multistate privileges. When inspectors explained that temporary licenses are restricted to the issuing state, she said she must have been misinformed.
The national nurse licensure database, NURSYS, confirmed the expired status of Staff A's multistate license. The temporary Idaho credential that replaced it appeared in the same record with the same license number, which may have contributed to the confusion about its scope.
The administrator, Staff O, was notified during the inspection that Staff A's credentials were not valid for practice in Washington. Staff O responded by designating another staff RN as acting Director of Nursing and providing that person's current credentials. By the following morning, Staff A had obtained a newly issued Washington State RN license and provided a copy to inspectors.
CMS cited the violation at a level of minimal harm or potential for actual harm, affecting a small number of residents. No inspection finding tied a specific resident injury to the period Staff A worked without valid Washington licensure.
What the record does not resolve is how long the gap existed before inspectors arrived. The multistate license expired, the temporary Idaho license was issued ten days later, and Staff A continued working in her role as the facility's Director of Nursing throughout. The inspection does not indicate whether the facility's credentialing process flagged the expiration, whether anyone reviewed the scope of the replacement license before she continued working, or how the complaint that triggered the inspection was connected, if at all, to the licensing question.
The Director of Nursing is not a floor position. The role carries responsibility for overseeing the nursing staff, clinical protocols, and care decisions across the facility. The person in that role practicing without valid state licensure is a different category of exposure than an unlicensed aide.
Staff A believed she was licensed. The facility, at least as the record reflects, did not catch the problem on its own.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Spokane Valley Health and Rehabilitation of Cascad from 2025-11-12 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 22, 2026 · Our methodology
SPOKANE VALLEY HEALTH AND REHABILITATION OF CASCAD in SPOKANE VALLEY, WA was cited for violations during a health inspection on November 12, 2025.
Ten days later, she obtained a temporary RN license, but it was issued by Idaho, not Washington.
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.