Eagle Rock Health And Rehabilitation Of Cascadia

was obtained prior to initiation of psychotropic medications for 1 of 3 residents (Resident #12)

medications without knowledge of the reason why medications were prescribed, the expected benefits, and the risks associated with the medications.

Findings include:Resident #12 was initially admitted to the facility on [DATE], and readmitted on [DATE], with multiple diagnoses including chronic obstructive pulmonary disease (disease process causing decreased lung functionality), depression, and cardiomegaly (an enlarged heart). A physician order dated 11/27/25, documented Resident #12 was to start Aripiprazole 5 mg by mouth one time per day. On 4/1/26 at 9:48 AM, the CEO presented the surveyor with Resident #12's signed Psychoactive Medication Informed Consent document dated 1/16/26, listing Aripiprazole 5mg, Buproprion 150mg, and Fluoxetine 40 mg.On 4/1/26 at 9:49 AM, the CEO stated, Resident #12 should have signed a Psychotropic Medication Acknowledgement Consent prior to administration of Aripiprazole but had not.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

facility failed to assess whether residents had the ability to self-administer their medications for 1 of

potential for adverse effects if medications were self-administered inappropriately by the resident.

Findings include: The facility's Self-Administration of Medication policy revised 9/16/25, documented residents may self-administer medications when it is determined to be safe and appropriate.the assessment will include whether bedside storage is appropriate.if self-administration is approved, a physician's order will be obtained and the care plan updated.Resident #59 was admitted to the facility on [DATE], and readmitted on [DATE], with multiple diagnoses including paraplegia (paralysis of the lower extremities) and depression. On 3/30/26 at 10:07 AM, observed in Resident #59's room one bottle of Artificial Tears eye drops and one bottle of Prednisolone Acetate eye drops sitting on resident's side table. On 3/30/26 at 10:22 AM, LPN #1 stated Resident #59 should not have had the Artificial Tears and Prednisolone Acetate eye drops at his bedside. On 3/30/26 at 1:27 PM, review of Resident #59's medical record documented the IDT self-administration assessment dated , 3/17/26, under A.

Assessment Criteria 15.

Can correctly administer eye drops or eye ointments according to proper procedure, ?Not applicable' was highlighted. On 3/30/26 at 2:06 PM, Resident #59's medical record included physician orders for:- Prednisolone Acetate ophthalmic suspension 1%, start date 3/19/26- Artificial Tears ophthalmic solution 0.2-0.2-1%, start date 3/20/26 On 3/31/26 at 5:17 PM, the CNO stated Resident #59 should not have had eye drops at his bedside and had not been approved by IDT for self-administration of eye medications.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

to participate in experimental research, and to formulate an advance directive.

record review and staff interview it was determined the facility failed to ensure a resident and their

was true for 1 of 22 residents (Resident #8) whose records were reviewed for Advance Directives.

This deficient practice created the potential for harm or adverse outcomes if the residents wishes were not followed or documented regarding their advance care planning.

Findings include: Resident #8 was admitted to the facility on [DATE], with multiple diagnoses including quadriplegia (paralysis of upper and lower limbs) and depression.On 3/31/26 at 9:02 AM, Resident #8's medical record contained a POST but had not documented an advance directive or documentation the facility informed or provided written information concerning the right to formulate an advance directive.On 3/31/26 at 10:48 AM, the Administrator provided the surveyor with a document titled, Understanding Advance Directives, with documented resident verbal consent and cosigned by two staff members dated 3/31/26. On 3/31/26 at 10:49 AM, the Administrator stated the facility only had POST documents for Resident #8.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

limited to receiving treatment and supports for daily living safely.

observations and interviews, it was determined the facility failed to ensure residents were provided

#212), shower rooms, and other areas throughout the facility which were observed.

This deficient practice created the potential for diminished quality of life and resident safety.

Findings include:The following areas were observed for clean and homelike environment: On 3/30/26 at 4:09 PM, observed Resident room [ROOM NUMBER]:Room door frame protective molding torn with sharp jagged edges.

On 3/31/26 at 2:08 PM, observed Resident room [ROOM NUMBER]:Electrical wall outlet broken with jagged edges. On 4/1/26 observed:a.Grand Teton Hall - Shower room tile floor with broken tile and missing grout at entry door. b.Palisades Hall - Shower room wall heater with broken and rusted areas to the front and sides of the heater.

The heater base broken with jagged edges and partially disconnected from the floor.

The tile floor with dark black residue in the grout and around the floor drain.

Several broken floor tiles in the middle of the shower room with open divets and dark black residue in the opened exposed areas. c.Mesa Hall - Shower room wall heater cover removed and lying on the floor next to the heater.

Wall heater with exposed wire on the bottom side of the heater. On 4/1/26 at 4:23 PM, CNA #14 stated the shower rooms do not look like they have been cleaned and should have been. On 4/2/26 at 10:26 AM, accompanied by the Maintenance Director observed Palisades Hall shower room stall with large amount of dark strands of hair in the drain and on the shower stall floor. On 4/2/26 at 10:30 AM, the Maintenance Director stated he was unaware of the needed repairs to room [ROOM NUMBER]'s door frame molding, room [ROOM NUMBER] electrical outlet, the heaters needed to be repaired, and the shower rooms do not look like they have been cleaned and should have been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

information including care plan goals and advance directive information was provided to the receiving hospital for his 11/16/25 discharge.

An eINTERACT Transfer Form V5 dated 2/23/26, documented Resident #11 was discharged to the hospital for pain, diarrhea, and elevated heart rate. Resident #11'smedical record had not included documentation that the required pertinent medical information including care plan goals and advance directive information was provided to the receiving hospital for his 2/23/26 discharge.

An eINTERACT Transfer Form V5 dated 3/7/26, documented Resident #11 was discharged to the hospital. Resident #11's medical record had not included documentation that the required pertinent medical information including care plan goals and advance directive information was provided to the receiving hospital for his 3/7/26 discharge. 5.Resident #28 was initially admitted to the facility on [DATE], and readmitted on [DATE], with multiple diagnoses including heart failure and COPD.

An eINTERACT Transfer Form V5 dated 11/15/25, documented Resident #28 was discharged to the hospital due to altered mental status. Resident #28's medical record had not included documentation that the required pertinent medical information including care plan goals and advance directive information was provided to the receiving hospital for her 11/15/25 discharge.

An eINTERACT Transfer Form V5 dated 3/19/26, documented Resident #28 was discharged to the hospital due to chest pain. Resident #28's medical record had not included documentation that the required pertinent medical information including care plan goals and advance directive information was provided to the receiving hospital for her 3/19/26 discharge.

On 4/2/26 at 10:54 AM, the CNO stated the nurses had completed the eINTERACT charting in Point Click Care but had not documented what forms were sent to the hospital with them and should have.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

discharge instructions were reviewed upon admission to the facility to assure physician orders were

were reviewed.

This failure placed these residents at risk of delayed respiratory care and assessments.

Findings include:1. Resident #37 was admitted to the facility on [DATE], with multiple diagnoses including chronic respiratory failure with hypoxia (tissues are deprived of adequate oxygen causing shortness of breath) and obstructive sleep apnea.On 3/30/26 at 8:14 AM, observed in Resident #37's room, sitting on his dresser, a CPAP machine (a mask and air pump to keep airways open during sleep).On 3/30/26 at 8:16 AM, Resident #37 stated he uses the CPAP machine at night.On 4/2/26 at 10:48 AM, the CNO stated Resident #37 did not have an order for his CPAP, it was not on his care plan or on his MDS and should have been. 2. Resident #9 was admitted to the facility on [DATE], with multiple diagnoses including COPD and Chronic Kidney Disease.On 3/30/26 at 9:37 AM, observed in Resident #9's room, next to her bed, an AVAP machine (a non-invasive ventilator that automatically adjusts pressure support to maintain a target tidal volume, ensuring consistent breathing support for patients with chronic respiratory failure).On 3/30/26 at 9:43 AM, Resident #9 stated she uses the AVAP machine at night to help her breath while she sleeps.Review of Resident #9's hospital Transfer Orders dated 2/9/26, documented, AVAP Max IPAP 16-19 cmH20 Min IPAP 6-9 cmH2) Max EPAP 12-14 cmH2) Min EPAP 6-12 cmH20 Rate 8-12 BPM Tidal volume 380 ml O2 bleed in at 2-8 liters with humidification to maintain spo2 89-90% Q shift on at HS and off in AM.On 3/31/26, Resident #9's medical record had not documented a physician orders for her AVAP machine use.On 4/1/26 at 10:49 AM, the CNO stated the AVAP was not on Resident #9's orders and should have been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

significant change in condition or status assessment MDS within 14 days to accurately reflect the

This deficient practice had the potential for negative outcomes if the resident was not assessed and cared for or monitored due to inaccurate assessments.

Findings include:Resident #4 was admitted to the facility on [DATE], with multiple diagnoses including chronic respiratory failure with hypoxia (a long-term, progressive inability of the lungs to oxygenate the blood sufficiently) and dementia.Resident #4's physician order dated 2/19/26, documented End of Life Care: Hospice Services.Resident #4's care plan documented hospice care started 2/19/26.On 3/31/26 at 5:10 PM, the MDS coordinator stated the facility had not completed a significant change in condition or status assessment MDS within 14 days of Resident #4 starting on Hospice care and should have.On 4/1/26 at 12:44 PM, the CNO stated the significant change in condition or status assessment MDS should have been completed on Resident #4 within 14 days of starting on Hospice care and had not been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

Level 1 Pre-admission Screening and Resident Review (PASARR I), was completed correctly for 1 of

for harm if residents required, but did not receive specialized services for mental health while residing in the facility.

Findings include:The facility's Pre-admission Screening and Resident Review (PASRR) Process dated 8/29/25, documented under Procedure1.

Ensure Level I PASRR screening has been completed on potential admissions prior to admission. 2. A negative Level I screen permits admission to proceed and end (the) PASRR process during the initial admission process. 3. A positive Level I screen necessitates an in-depth evaluation of the individual by the state-designated authority, known as PASRR Level II. 3a.

When a Level II PASRR screening is warranted, it should be obtained (as well as determination letter) prior to admission.Resident #13 was initially admitted to the facility on [DATE], and was readmitted on [DATE], with multiple diagnoses including post-traumatic stress disorder and joint replacement surgery aftercare.Resident #13's Level 1 PASRR dated 3/3/26 and 3/13/26, had not documented he had Post-Traumatic Stress Disorder and anxiety disorders which would have triggered the need for a Level II PASRR.Resident #13's medical record dated 3/3/26, documented medical diagnosis of Post-Traumatic Stress Disorder, Chronic.On 3/30/26 at 12:00 PM, Resident #13 medical record had not documented a Level II PASRR had been completed.On 3/31/26 at 2:00 PM, the Resident Support Services Assistant stated the Level II PASRR dated 3/30/26, had just been completed and faxed to Mental Health for review.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

multiple diagnoses including COPD and obstructive sleep apnea.

discussed with him or his resident representative.

Resident #21 was admitted to the facility on [DATE], with multiple diagnoses including interstitial lung disease (a group of over 200 disorders causing inflammation or scarring in the lung tissue between air sacs, making it difficult to breathe and get oxygen into the bloodstream) and heart failure. Resident #21's medical record had not documented that a baseline care plan was provided and discussed with him or his resident representative. Resident #28 was initially admitted to the facility on [DATE], and readmitted on [DATE], with multiple diagnoses including heart failure and COPD. Resident #28's medical record had not documented that a baseline care plan was provided and discussed with him or his resident representative.

On 4/1/26 at 4:26 PM, the CNO stated there was no documentation that the residents or their representatives had received a copy of their baseline care plans.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

actions that can be measured.

observation, policy review, interview, and record review, the facility failed to develop and implement

whose care plan was reviewed.

This deficient practice of not developing and implementing care plans placed residents at risk to their health and wellbeing with negative outcomes if services were not provided or provided incorrectly.

Findings include:The facility's Comprehensive Care Plan and Conferences policy dated 9/3/25, documented the care plan will reflect the residents' individual conditions, risks, needs, behaviors, cultural values, and preferences, and will include measurable goals, appropriate interventions, and realistic timeframes.Resident #13 was initially admitted to the facility on [DATE], and was readmitted on [DATE], with multiple diagnoses including post-traumatic stress disorder and joint replacement surgery aftercare.Resident #13's medical record dated 3/3/26, documented medical diagnoses of Post-Traumatic Stress Disorder, Chronic.On 3/31/26 at 2:09 PM, Resident #13's care plan had not addressed his Post-Traumatic Stress Disorder diagnosis with any focus or interventions/tasks. On 4/1/26 at 12:47 PM, the CNO stated Resident #13's Post-Traumatic Stress Disorder diagnosis should have been care planned and had not been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

reviewed, and revised by a team of health professionals.

observation, interview, policy review, and record review, it was determined the facility failed to

2 of 22 residents (#2 and #12) whose care plans were reviewed.

This placed residents at risk for adverse outcomes if care and services were not provided due to care plans not being revised as residents' needs changed.

Findings include.

The facility's Resident Care Plan Revisions policy, revision date 9/3/25, documented.updates to the care plan will occur as needed based on the residents' response to interventions or changes in condition. Resident #2 was initially admitted to the facility on [DATE], and readmitted on [DATE], with multiple diagnoses including fracture of the right tibia (lower leg bone) and anxiety. On 3/30/26 at 8:19 AM, Resident #2's physician order dated 3/6/26 - Edema Management Right lower leg: edema, apply Tubi grip on AM, off PM. On 3/30/26 at 11:33 AM, observed Resident #2 sitting in her room not wearing a Tubi grip to her right lower leg. On 4/1/26 at 3:38 PM, during interview Resident #2 stated her right lower leg is swollen and has been for a while.

On 4/2/26 at 10:33 AM, observed Resident #2 sitting in her room not wearing a Tubi grip to her right lower leg. On 4/2/26 at 11:06 AM, reviewed Resident #2's care plan with no documentation regarding Tubi grip to right lower leg. On 4/2/26 at 11:07 AM, Resident #2's TAR reviewed with no documentation regarding Tubi grip to right lower leg. On 4/2/26 at 1:17 PM, the CNO stated Resident #2's care plan and TAR should have been updated when the resident received physician orders for the Tubi grip and had not been. Resident #12 was initially admitted to the facility on [DATE], and readmitted on [DATE], with multiple diagnoses including chronic obstructive pulmonary disease (disease process causing decreased lung function), depression, and cardiomegaly (an enlarged heart). Resident #12's medical record documented physician order dated 3/9/26, Oxygen at 3LPM continuously per nasal cannula via O2 concentrator and/or tank. On 4/1/26 at 4:22 PM, review of Resident #12's care plan documented Oxygen Settings: -O2 via nasal prongs at 0-4L prn to maintain saturation at 90% or greater - date initiated 2/10/25.-Oxygen 2L/min continuously via NC - date initiated 6/24/25. On 4/1/26 at 4:25 PM, the CNO stated Resident #12's care plan should have been updated with the oxygen order dated 3/9/26, and had not been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

Review of Resident #21's medical record documented a physician's order dated 2/25/26, for Ertapenem Sodium Injection Solution Reconstituted 1 GM (broad-spectrum antibiotic).

Use 1 gram intravenously in the morning for sepsis r/t pneumonia until 3/1/26.

On 3/31/26 at 9:38 AM, RN #4 stated she could not find orders for Resident #21's PICC line.

She also stated the PICC line may have been discontinued but either way the PICC line should of been removed or had orders for it.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

Finding include:The facility's Medication Administration Enteral Assess Device policy, release date 9/16/25, directed staff to follow the general professional standards for safe administration of medications and verify tube placement per facility protocol.Resident #59 was admitted to the facility on [DATE], with multiple diagnoses including paraplegia (paralysis of the legs and lower body, typically caused by spinal injury or disease) and dysphagia (difficulty swallowing).Resident #59's physician's order dated 1/21/26, documented Enteral Tube: May Crush meds or use liquid form via tube.

Check tube placement via auscultation prior to medication administration. On 4/1/26 at 9:00 AM, observed RN #2 administered 30 milliliters of water in Resident #59's enteral tube. RN #2 then placed 20 milliliters of hydroxyzine HCl liquid (anti-anxiety medication) in his enteral tube. RN # 2 then flushed Resident #59's enteral tube with 30 milliliters of water. RN #2 did not verify tube placement prior to medication administration.On 4/1/26 at 9:12 AM, RN #2 stated she was not sure what the facility's policy was on checking tube placement and residual prior to administering medication.On 4/1/26 at 9:46 AM, the CNO stated the facility's g-tube policy does not state to check residual or placement before feedings or medication administration.

Placement is checked with a x-ray when it is put in only.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

[DATE], with multiple diagnoses including acute osteomyelitis of right ankle and foot (serious, often chronic bone infection (usually Staphylococcus aureus) requiring prompt treatment to prevent permanent damage) and lumbar vertebra fracture.

On 3/30/26 at 1:01 PM, observed Resident #53 had not been using the oxygen when the surveyor visited. Resident #53's medical record documented SpO2 on 3/29/26 at 10:21 of 88%, and on 3/30/26 at 10:57 of 88%, with both times documented he had not been on his supplemental oxygen and was using room air only. Resident #53's physician oxygen order was for 2 lpm continuously per nasal cannula to keep oxygen saturations at or above 90%. Resident #53's care plan documented monitor respiratory status and oxygen saturation, and oxygen at 2 LPM continuously per nasal cannula to keep oxygen saturation at or above 90%.

On 4/2/26 at 10:46 AM, the CNO stated nursing staff should have made sure Resident #13 and Resident #53 were using their oxygen per physician's order, Resident #53's oxygen should not be allowed to bleed into the PAP device when it was not in use, and he was not aware of the requirement of the [NAME] Respironics pressure valve and was not aware if any PAP devices in the facility had the pressure valve.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

provide adequate pain management.

This was true for 1 of 1 resident (Resident #53) whose medical

distress.

Findings include:The facility's Pain Assessment and Management policy dated 9/2/25, documented under Procedure, Pain Management, 2.

The facility should address/treat the underlying causes of the pain, to the extent possible, a. developing and implementing both non-pharmacological and pharmacological interventions/approaches to pain management.Resident #53 was initially admitted to the facility on [DATE], and was readmitted to the facility on [DATE], with multiple diagnoses including acute osteomyelitis of right ankle and foot (serious, often chronic bone infection (usually Staphylococcus aureus) requiring prompt treatment to prevent permanent damage) and lumbar vertebra fracture.Resident #53's physician order dated 2/11/26, and 3/20/26, documented Hydrocodone-Acetaminophen Oral Tablet 5-325 MG, every 4 hours as needed.Resident #53's care plan dated 11/10/25, documented facility will attempt non-pharmacological pain intervention as part of treatment plan.On 3/30/26 at 1:38 PM, Resident #53's MAR documented no attempt to use non-pharmacological pain management prior to administering pain medications on 3/17/26, 3/18/26, 3/20/26, 3/23/26, 3/24/26.On 4/1/26 at 3:50 PM, the CNO stated Resident #53 should have had non-pharmacological pain management offered prior to administering the hydrocodone medication and had not been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

way that maximizes each resident's well being.

personnel record review, policy review, facility assessment, resident record review, and staff

resident needs.

This was true for 1 of 5 nurses observed for medication administration.

This failure had the potential to affect all residents in the facility and increased the risk of harm to residents.

Findings include:The facility's Medication Administration policy revision date 9/10/25, stated if parameters are indicated, take (or delegate to appropriate qualified staff to take) vital signs prior to preparing the medication. Resident #21 was admitted to the facility on [DATE], with multiple diagnoses including Interstitial lung disease (a group of over 200 disorders causing inflammation or scarring in the lung tissue between air sacs, making it difficult to breathe and get oxygen into the bloodstream) and heart failure.On 3/30/26 at 9:35 AM, LPN #2 gave Resident #21 his medication which included his Metoprolol Succinate ER (beta-blocker used to treat high blood pressure).

After Resident #21 was done taking his medication LPN #2 checked his blood pressure.Resident #21's physician's order dated 2/26/25, stated Metoprolol Succinate ER Oral Tablet Extended Release 24 Hour 25 MG (Metoprolol Succinate).

Give 12.5 mg by mouth in the morning for Hypertension Hold for SBP < 100 or Heart Rate < 50.On 3/31/26 at 3:59 PM, the CNO stated the nurse should have checked Resident 21's vital signs before giving him his medication.Review of LPN #2's Medication Administration- oral competency form documented she had completed training.

The form documented Vital sign parameters are taken per facility practice before pouring medication.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

potential to affect all residents residing in the facility and their representatives, visitors, and others

following dates and times were missing daily staffing sheets or staffing data on the daily staffing sheets. - 5/6/25 No RN or LPN data listed for day and evening shifts - 9/8/25 No RN or LPN data listed for evening shift - 9/19/25 No CNA data listed for day/evening/night shifts - 12/7/25 Daily staffing sheet missing - 12/20/25 Daily staffing sheet missing - 12/21/25 Daily staffing sheet missing - 12/22/25 Only 1 RN for 8 hours listed for evening shift, no licensed nurses scheduled for day or night shifts.On 3/31/26 at 4:00 PM, the Staffing Coordinator stated the missing staffing data and sheets from those dates listed should not have been missing but was.

professional principles; and all drugs and biologicals must be stored in locked compartments,

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on

medications available for residents were labeled, dated, and were secure and inaccessible to unauthorized staff and residents; this was true for 2 of 2 medication carts inspected and 1 of 1 treatment carts observed.

This failure created the potential for residents to receive expired medications with decreased efficacy, the potential for adverse effects if residents self-administered medications inappropriately, and the potential for residents to obtain prescribed wound care supplies used for other residents and presented the risk for cross-contamination of wound care products stored in the treatment cart.

Findings include:The facility's Medication Storage In The Facility policy effective date May 2019, documented the following: - All medications dispensed by the pharmacy are stored in the container with the pharmacy label. -Outdated, contaminated, or deteriorated medications and those in containers that are cracked, soiled, or without secure closures are immediately removed from inventory, disposed of according to procedures for medication disposal (See Section IE: DISPOSAL OF MEDICATIONS AND MEDICATION-RELATED SUPPLIES), and reordered from the pharmacy (See IC#: ORDERING AND RECEIVING NON-CONTROLLED MEDICATIONS FROM THE DISPENSING PHARMACY), if the current order exists. - Certain medications or package types, such as IV solutions, multiple dose injectable vials, opthalmics, nitroglycerin tablets, blood sugar testing solutions and strips, once opened, require and expiration date shorter than the manufacturer's expiration date to ensure medication purity and potency. - No expired medication will be administered to a resident. - All expired medication will be removed from the active supply and destroyed in the facility, regardless of amount remaining.

The medication will be destroyed in the usual manner. On 4/1/26 at 6:43 AM, medication storage observed of the Yellowstone Hall medication cart with LPN #1 present observed the following:- a bottle of eye drops with the illegible label and an open date of 12/20/25.- a bottle of eye drops with the illegible label and an open date of 2/20/26.- a bottle of glucose strips with no open date. On 4/1/26 at 6:56 AM, LPN #1 stated the eye drops are good for 30 days after opening and should have been wasted.

The label is also faded and can't be read so the drops should not be used.

The glucometer strips are good for 30 days after opening and should be thrown away since they were not dated when they were opened. On 4/1/26 at 9:47 AM, the CNO stated the eye drop bottles should be dated with open date and he would have to check the pharmacy policy on how long they are good for. On 4/1/26 at 3:22 PM, observed the treatment cart unlocked outside room [ROOM NUMBER]. On 4/1/26 at 3:28 PM, LPN #3 stated the treatment cart had medicated creams in it and should have been locked. On 4/2/26 at 9:57 AM, medication storage observation completed of the Mesa Falls Hall medication cart with RN #5 present observed the following: - undated bottle glucose test strips On 4/2/26 at 10:04 AM, RN #2 stated the test strips should have been dated when open and she was not sure how long they were good for after opening.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401

multiple diagnoses including chronic obstructive pulmonary disease (disease process causing decreased lung functionality), depression, and cardiomegaly (an enlarged heart). Resident #12's physician oxygen order dated 3/9/26, documented oxygen 3 LPM continuously per nasal cannula via O2 concentrator and/or tank.

On 4/2/26 at 10:37 AM, observed Resident #12 in her room not wearing her oxygen nasal cannula.

On 4/2/26 at 10:42 AM, observed CNA #13 enter Resident #12's room, CNA picked up the oxygen nasal cannula off the floor and assisted Resident #12 in placing her nasal cannula.

On 4/2/26 at 10:45 AM, CNA #13 stated the oxygen nasal cannula and tubing should have been discarded and replaced before giving it to Resident #12.

On 4/2/26 at 1:55 PM, the CNO stated oxygen supplies should be discarded and replaced weekly as ordered or when the supplies have been found on the floor and had not been.

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Eagle Rock Health and Rehabilitation of Cascadia 840 East Elva Street Idaho Falls, ID 83401