Resident 7 told inspectors on November 24 that the IV saline lock was placed about a week ago to deliver fluids because they were dehydrated. They received the fluids one time and the catheter had not been used since.
The resident had diagnoses of lung disease, diabetes, and low blood pressure. They were alert and able to communicate their needs.
A physician had ordered the IV catheter insertion for a one-time fluid administration, which nurses completed and documented on November 18 at 11:03 PM. But a second order instructing staff to follow facility policy for flushing and maintaining the IV site never appeared on the resident's medication administration record.
Staff D, a licensed practical nurse, explained during an interview that routine IV catheter care required flushing every shift to prevent clogs. The saline flushes were supposed to be documented on the medication record.
Without the required maintenance, IV catheters can become blocked and unusable. More critically, they can develop clots or infections that pose serious health risks to patients.
The facility's own policy, titled "Intravenous (IV, by vein) Therapy," required that any IV order be accurately transcribed to the appropriate forms and documented in the resident's medical record.
Staff G, the assistant director of nursing, acknowledged the violation when shown Resident 7's September medication record. There was no order instructing staff to document the required saline flushes every shift, they admitted, and there should have been.
The facility had failed to follow both their own policy and the physician's order for flushing the IV catheter.
When inspectors asked Staff B whether the medical record showed staff had monitored and addressed Resident 24's change in condition, the employee said only, "I will find information." No additional details were provided.
The inspection found that nursing staff had left a medical device in a vulnerable resident's body without following basic safety protocols designed to prevent complications. The resident continued to carry the unused IV catheter in their wrist while staff ignored the physician's maintenance instructions.
Federal regulations require nursing homes to ensure that residents receive proper medical care according to physician orders and facility policies. The failure to transcribe and follow IV maintenance orders represented a breakdown in both documentation systems and patient safety protocols.
The violation affected few residents but demonstrated gaps in the facility's ability to implement basic medical procedures correctly. An IV saline lock requires regular flushing to remain functional and safe, yet staff allowed the device to remain in place for days without the ordered maintenance care.
Resident 7 remained in their room with the week-old catheter, unaware that their nursing care had fallen short of both medical standards and facility policy.
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 2025-11-24 including all violations, facility responses, and corrective action plans.
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