Eagle Rock Health: Oxygen Order Violations - ID
Resident 53 had blood oxygen readings of 88% on two consecutive days in late March, well below the 90% threshold required by his physician's orders. Both times, medical records showed he wasn't using his supplemental oxygen and was breathing only room air.
The resident had been readmitted to the facility with serious medical conditions including acute osteomyelitis of his right ankle and foot — a severe bone infection that typically requires prompt treatment to prevent permanent damage — and a lumbar vertebra fracture.
His physician had ordered oxygen at 2 liters per minute continuously through a nasal cannula specifically to keep his oxygen saturations at or above 90%. His care plan documented the same requirement: monitor respiratory status and oxygen saturation, with oxygen at 2 LPM continuously to maintain proper levels.
When an inspector visited Resident 53 on March 30 at 1:01 PM, the patient wasn't using his oxygen.
The facility's Chief Nursing Officer acknowledged the failures during an interview on April 2. Nursing staff should have ensured both Resident 13 and Resident 53 were using their oxygen per physician orders, the CNO stated.
Resident 13 presented a similar problem. A registered nurse told inspectors on March 31 that the resident doesn't use his oxygen during the day, then asked if there was actually an order requiring him to do so.
The CNO revealed additional equipment problems during the inspection. He said Resident 53's oxygen should not be allowed to bleed into his PAP device when not in use. He also admitted he wasn't aware of requirements for pressure valves on Respironics devices and didn't know if any PAP machines in the facility had the necessary pressure valves.
Blood oxygen levels below 90% can cause serious health complications, particularly for residents with existing medical conditions like bone infections and spinal fractures. Normal oxygen saturation levels range from 95% to 100% for healthy individuals.
The violations occurred despite clear documentation in both residents' medical records and care plans specifying continuous oxygen therapy requirements. Nursing staff are responsible for ensuring residents receive prescribed treatments and monitoring their vital signs regularly.
Federal inspectors classified the violations as causing minimal harm or potential for actual harm, affecting few residents. The facility must submit a plan of correction addressing how staff will ensure residents receive prescribed oxygen therapy and proper equipment maintenance.
The inspection report didn't specify how long the residents had been going without their prescribed oxygen or whether the facility had previously identified the compliance problems. Medical records showed the pattern of low oxygen readings and non-compliance continued for at least two days before inspectors documented the violations.
Eagle Rock Health and Rehabilitation operates on East Elva Street in Idaho Falls. The facility must work with state survey agencies to address the oxygen therapy compliance issues identified during the federal inspection.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Eagle Rock Health and Rehabilitation of Cascadia from 2026-04-02 including all violations, facility responses, and corrective action plans.
Additional Resources
- View all inspection reports for Eagle Rock Health and Rehabilitation of Cascadia
- Browse all ID nursing home inspections
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 15, 2026 · Our methodology
Eagle Rock Health and Rehabilitation of Cascadia in Idaho Falls, ID was cited for violations during a health inspection on April 2, 2026.
Resident 53 had blood oxygen readings of 88% on two consecutive days in late March, well below the 90% threshold required by his physician's orders.
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.
Frequently Asked Questions
- What happened at Eagle Rock Health and Rehabilitation of Cascadia?
- Resident 53 had blood oxygen readings of 88% on two consecutive days in late March, well below the 90% threshold required by his physician's orders.
- How serious are these violations?
- Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.
- What should families do?
- Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in Idaho Falls, ID, (5) Report any new concerns directly to state authorities.
- Where can I see the full inspection report?
- The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from Eagle Rock Health and Rehabilitation of Cascadia or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 135092.
- Has this facility had violations before?
- To check Eagle Rock Health and Rehabilitation of Cascadia's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.