Federal inspectors found multiple residents at Spokane Valley Health and Rehabilitation of Cascad were not receiving regular bathing assistance, with documentation gaps spanning weeks and staff acknowledging the inconsistent care.
Resident 88 described the problem directly during a September interview with inspectors. He said he was scheduled for baths on Tuesdays and Fridays but "was not getting showered regularly." The resident explained he had been bathed the previous Friday but before that, his last shower was three weeks earlier.
His care plan, implemented in March, specifically noted he preferred twice-weekly baths and needed assistance from one nursing staff member. The plan also required staff to offer bed baths when regular bathing was refused or the resident couldn't tolerate it.
Documentation told a different story than the care plan promised. Resident 88 was bathed September 2, then not again until September 16 — a 14-day gap. After baths on September 19 and 23, he waited another week until September 30.
October was worse. Inspectors found no documentation showing Resident 88 received any baths during the entire month.
The most severe lapse occurred between his September 30 bath and his next documented shower on November 4 — 34 days. At the time of the inspection on November 24, his most recent bath had been November 11, seven days earlier.
A second resident faced similar neglect. Resident 68 went 10 days between baths, from October 25 to November 5. When staff documented that the resident refused bathing on November 8, no records showed anyone offered the alternative bed bath required by the care plan.
Licensed Practical Nurse Staff P confirmed the systemic nature of the problem. In a September interview, she explained all bathing documentation was kept electronically, with no shower logs or paper backup records. When inspectors returned in November for a follow-up interview, Staff P acknowledged that "residents were not being bathed consistently" after reviewing the documentation gaps.
The facility's quarterly assessment for Resident 88 painted the scope clearly. Conducted in late September, it documented that the cognitively intact resident "had not been bathed during the seven days of the assessment period" and needed assistance from one nursing staff member for bathing.
Both residents' situations violated federal requirements for nursing homes to ensure residents receive appropriate personal hygiene care. The inspection classified the violations as causing "minimal harm or potential for actual harm" affecting "few" residents.
The documentation problems extended beyond individual cases. Inspectors noted the facility's electronic record-keeping system failed to capture the reality of missed care, with Staff P's admission revealing that the bathing schedule breakdowns were more widespread than individual resident records suggested.
Resident 88's case particularly highlighted how cognitive awareness made the neglect more troubling. Unlike residents who might not remember or communicate about missed care, he could clearly articulate his preferences and track when promised services weren't delivered.
The inspection report referenced additional staffing concerns that contributed to the bathing problems, noting "See F725 - Sufficient staffing for additional information." This suggests the hygiene failures were connected to broader staffing inadequacies at the facility.
Federal inspectors completed their review November 24, documenting a pattern of care that left residents waiting weeks for basic hygiene assistance despite clear care plans and resident requests for help staying clean.
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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