Spokane Valley Health And Rehabilitation Of Cascad

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

plan. - Resident 68 was bathed on 11/05/2025, 10 days from the last shower on 10/25/2025.

Documentation showed the resident refused to be bathed on 11/08/2025, however, no documentation was found that showed Resident 68 had been offered a bed bath. <Resident 88>The 09/23/2025 quarterly assessment documented Resident 88 was cognitively intact to make decisions regarding their care, and needed assistance from one nursing staff for bathing. In addition, the assessment documented the resident had not been bathed during the seven days of the assessment period. During a resident interview on 09/25/2025 at 3:17 PM, Resident 88 stated he wanted to stay clean, was scheduled to be bathed on Tuesdays and Fridays, but was not getting showered regularly. Resident 88 further stated they were bathed Friday (09/19/2025), and the last shower prior to that had been three weeks ago. Review of the ADL care plan documented interventions related to bathing were implemented on 03/17/2025 and informed nursing staff that Resident 88 preferred to be bathed twice a week, needed assistance from one nursing staff, and a bed bath was to be provided if bathing was refused or Resident 88 was unable to tolerate being bathed.Review of the Documentation Summary Report from 09/01/2025 through 11/18/2025 documented

the following:- Resident 88 was bathed on 09/02/2025, and was not bathed again until 09/16/2025, 14 days later. Bathing occurred on 09/19/2025 and 09/23/2025, but the next bath did not occur until a week later on 09/30/2025.- No documentation was found that showed Resident 88 had been bathed in October 2025.Resident 88 was bathed 11/04/2025, a period of 34 days after last being bathed, and at the time of the review, the last documented bath occurred on 11/11/2025, seven days ago. <Interviews>In an interview on 09/30/2025 at 9:57 AM, Staff P, Licensed Practical Nurse, stated all documentation for bathing/showers was done in the resident's electronic records, there was not a shower log or paper documentation. In a follow-up

interview on 11/21/2025 at 7:00 AM, After discussion of bathing documentation, Staff P confirmed residents were not being bathed consistently. See F-F725 - Sufficient staffing for additional information

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Spokane Valley Health and Rehabilitation of Cascad

East 17121 Eighth Avenue Spokane Valley, WA 99016

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Level of Harm - Minimal harm or potential for actual harm

The above findings were shared with Staff B on [DATE REDACTED] at 10:45 AM. Staff B stated, I will find information, when asked if the medical record showed the staff monitored and promptly addressed Resident 24's change in condition preceding [DATE REDACTED]. No further information was provided. <Failure To Clarify a Physician's Order>

Residents Affected - Few

A [DATE REDACTED] facility policy titled Intravenous (IV, by vein) Therapy showed, any IV order was accurately transcribed to the appropriate forms and documented in the resident's medical record.

According to a quarterly assessment dated [DATE REDACTED], Resident 7 had diagnoses of lung disease, diabetes, and hypotension (low blood pressure). They were alert and able to make their needs known.

In an interview on [DATE REDACTED] at 11:34 AM, Resident 7 was observed in their room. They had an IV saline lock (A tube inserted into a vein that does not have fluid running through it. Nurses periodically flushed with saline solution to prevent blockage) in their right wrist. Resident 7 stated that it was placed about a week ago to get IV fluids because they were dehydrated. They further clarified that they only needed fluids one time, and it had not been used since.

A review of Resident 7's orders included a [DATE REDACTED] order to insert an IV catheter to administer fluids, for one time only. This order was signed as completed at [DATE REDACTED] at 11:03 PM on the [DATE REDACTED] Treatment Administration Record (TAR). Another [DATE REDACTED] order instructed the nurses to follow facility IV policy for flushing and site maintenance. This order was not found on the September TAR or MAR.

During an interview on [DATE REDACTED] at 10:24 AM, Staff D, Licensed Practical Nurse, stated that routine care of an IV catheter included flushing it every shift to make sure it did not get clogged. The saline flushes were documented on the MAR.

During an interview on [DATE REDACTED] at 11:31 AM, Staff G, Assistant Director of Nursing, stated that an IV should be flushed every shift if not in use, or the IV line could clog and not be usable. When Staff G reviewed Resident 7's September MAR, they acknowledged there was no order that instructed the staff to document saline flushes every shift and there should have been, and the facility did not follow their policy and the provider order for flushing the IV catheter.

Reference WAC 388-97-1060(1)

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Spokane Valley Health and Rehabilitation of Cascad

East 17121 Eighth Avenue Spokane Valley, WA 99016

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

staff were able to call for assistance if needed. At 11:52 AM during the continued interview related to staffing, Staff FF stated Staff Y, restorative aide, would also be pulled to work the floor if needed. When informed there were concerns also with restorative services not being provided, Staff FF stated they were not aware. In an interview on 11/24/2025 from 12:07 PM to 12:25 PM with Staff A, Administrator and Staff B, Director of Nursing, concerns were expressed with the facility not having adequate staff to complete bathing and restorative services. Staff A stated staffing needs were based on resident census and the facility always referred to the State minimum requirements. Both Staff A and Staff B acknowledged there had been issues with residents not being bathed, but believed that there was adequate nursing staff to complete and it was a matter of disciplinary action. When informed that restorative services were not being completed due to the restorative aide being pulled to work the floor, neither Staff A nor Staff B stated they were aware. Please see F-F677 ADL care for Dependent Residents and F-F688 Increase/Prevent Decrease in ROM/Mobility for additional information.Reference (WAC): 388-97-1080(1)

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