One contract nurse worked nine shifts between November and December without the mandatory screening. Their first day providing unsupervised care was November 2, 2025, according to facility records reviewed by inspectors.
The scheduling coordinator admitted the failure during a late-night interview on December 23. When presented with what appeared to be a background check authorization form dated July 8, 2024, the coordinator initially thought it was the actual completed screening.
"After reviewing the form, Staff B stated that was not the completed BGC," inspectors wrote, using the facility's abbreviation for background checks. "They stated they were aware that all staff were required to have an approved BGC prior to working unsupervised with residents, including agency-contracted staff."
The coordinator took responsibility for the oversight. "I missed this and I own it," they told inspectors.
But the problem extended far beyond one nurse.
During a follow-up interview 22 minutes later, the scheduling coordinator revealed four additional agency nurses were working without proper clearances. The coordinator presented authorization forms for the other contract staff, but acknowledged these were only the initial paperwork, not completed background checks.
One authorization form was dated September 15, 2025. Another was dated December 9, 2025. A third bore the date August 21, 2025. The fourth form initially showed a date of October 3, 1982, though the administrator later clarified this should have read October 3, 2025.
None represented actual completed screenings.
The scheduling coordinator confirmed all five agency nurses needed the required background checks before working with residents. "Staff B stated the BGC authorization forms were the same as the other (Staff C's) and all staff needed to have the required BGC prior to working," according to the inspection report.
Federal inspectors interviewed the facility administrator that afternoon about the screening process. The administrator explained that potential staff must complete background checks with clearance before working unsupervised with residents. If a secondary review was indicated, that also needed completion prior to starting work.
The process was clear. The execution was not.
The scheduling coordinator admitted the facility failed to follow its own procedures. "Staff B stated the process was not followed for BGCs," inspectors documented.
Washington state regulations require nursing homes to conduct background checks on all staff before they begin working unsupervised with residents. The regulation applies equally to facility employees and contracted agency workers.
The violation affected multiple residents over several weeks. Inspection records show the first agency nurse worked six shifts in November and three shifts in December without proper screening. The other four nurses' work schedules were not detailed in the inspection report, but all had worked at the facility without completed background checks.
Federal inspectors classified the violation as causing minimal harm or potential for actual harm to some residents. The December 23 complaint investigation focused specifically on background check compliance.
The facility's admission that it "missed" the requirement for five separate contract nurses suggests systematic problems with oversight of agency staff. Each nurse required individual screening, and each case represented a separate failure to follow state regulations designed to protect nursing home residents.
The scheduling coordinator's initial confusion between authorization forms and completed background checks indicates potential gaps in understanding the screening requirements. The coordinator first believed a July 2024 authorization form constituted an actual background check, only recognizing the error when inspectors pressed for clarification.
Agency nurses often fill critical gaps in nursing home staffing, particularly during shortages or high-demand periods. But state regulations make no distinction between facility employees and contract workers when it comes to background screening requirements.
The administrator's description of the proper process highlighted what should have happened. Background checks with clearance must be completed before any unsupervised resident contact. Secondary reviews, when required, must also be finished before starting work.
Instead, five agency nurses provided direct care to nursing home residents for weeks or months while their background screenings remained incomplete. The first nurse alone worked nine shifts over two months without the required clearance.
The violation represents a fundamental breakdown in the facility's screening protocols for contract staff. Each authorization form presented to inspectors was dated differently, suggesting the nurses started at various times throughout the fall of 2025, yet none had completed the mandatory background checks.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Avalon Health & Rehabilitation Center - Pasco from 2025-12-23 including all violations, facility responses, and corrective action plans.
Additional Resources
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