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Complaint Investigation

Avalon Care Center At Northpointe

Inspection Date: September 17, 2025
Total Violations 2
Facility ID 505496
Location SPOKANE, WA
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Inspection Findings

F-Tag F0760

Pharmacy Service Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

04/01/2025, then 70mg daily starting 04/02/2025. Further review showed the actual dose of methadone given to Resident 1 was 50mg daily each day from 04/01/2025 to 04/07/2025. In an interview on 07/22/2025 at 2:10 PM, Staff A, Director of Nursing, stated after Resident 1's suspected overdose on 03/28/2025 the facility received orders from the OTP to taper the resident's methadone dose back up to 70mg daily, but the order was changed to 50mg daily by Staff B, Physician Assistant. Staff A stated Staff B gave a verbal order for the dose change due to recommendations by the resident's hepatology clinic (branch of medicine that focuses on diseases affecting the liver, gall bladder, bile ducts, and pancreas) to reduce or eliminate the methadone use on 04/02/2025.Review of Resident 1's April 2025 Medication Administration Record showed facility staff administered 50mg of methadone to the resident daily from 04/01/2025 to 04/12/2025, except for 04/08/2025 when the resident received their methadone during their appointment at the OTP. On 05/30/2025 at 2:55 PM Collateral Contact 1 (CC1) stated when Resident 1's methadone vials were returned to the OTP in April 2025 the vials should have been empty, but instead still had dose amounts remaining. Per CC1 the facility did not report giving the resident less methadone than ordered by the OTP until the OTP staff asked about the remaining dose amounts.In an interview on 07/22/2025 at 12:52 PM, Staff D, Administrator, stated the facility did not have a specific policy related to residents who utilized an OTP, but the facility followed the OTP provider's orders for methadone use. Staff D further stated that Resident 1's case was difficult due to medical providers at the hospital and other appointments expressing concerns with the resident's use of methadone with their other underlying medical conditions.Review of a provider progress note dated 04/02/2025 showed Resident 1 was to continue receiving 70mg of methadone daily and that Staff B would follow-up with the resident through the next several days regarding the hepatology team's recommendations. There was no documentation the OTP was consulted about the resident's methadone dose and/or attempts to coordinate care between the OTP medical provider(s) and the resident's hepatology provider(s).Staff B was not available for interview during

the course of the survey.In an interview on 09/17/2025 at 3:53 PM, Staff C, Medical Director, stated which type of medical provider was responsible for managing methadone doses was dependent upon the resident's diagnosis. Per Staff C, if methadone was used for pain facility providers could adjust the dose, but if the methadone was used for OUD then the facility should send the resident to the OTP for dosing.

Staff C stated if there were multiple types of providers involved in a resident's care who disagreed on treatment, they would coordinate with the various providers directly. Staff C clarified they were not the medical director during April 2025 and had no additional information related to Resident 1's methadone order changes.Reference: (WAC) 388-97-1060 (3)(k)(iii)

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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

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Avalon Care Center at Northpointe

9827 North Nevada Spokane, WA 99218

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)

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F-Tag F0841

Nursing and Physician Services Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0841 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

the resident daily from 04/01/2025 to 04/12/2025, except for 04/08/2025 when the resident received their methadone during their appointment at the OTP. Further review showed no record of coordination with the opioid treatment program provider to change dosage of MOUD. On 05/30/2025 at 2:55 PM Collateral Contact 1 (CC1) stated when Resident 1's methadone vials were returned to the OTP in April 2025 the vials should have been empty, but instead still had dose amounts remaining. Per CC1 the facility did not report giving the resident less methadone than ordered by the OTP until the OTP staff asked about the remaining dose amounts.In an interview on 07/22/2025 at 12:52 PM, Staff D, Administrator, stated the facility did not have a specific policy related to residents who utilized an OTP, but the facility followed the OTP provider's orders for methadone use. Staff D further stated that Resident 1's case was difficult due to medical providers at the hospital and other appointments expressing concerns with the resident's use of methadone with their other underlying medical conditions.Review of a provider progress note dated 04/02/2025 showed Resident 1 was to continue receiving 70mg of methadone daily and that Staff B would follow-up with the resident through the next several days regarding the hepatology team's recommendations. There was no documentation the OTP was consulted about the resident's methadone dose and/or attempts to coordinate care between the OTP medical provider(s) and the resident's hepatology provider(s).Staff B was not available for interview during the course of the survey.In an interview

on 09/17/2025 at 3:53 PM, Staff C, Medical Director, stated which type of medical provider was responsible for managing methadone doses was dependent upon the resident's diagnosis. Per Staff C, if methadone was used for pain facility providers could adjust the dose, but if the methadone was used for OUD then the facility should send the resident to the OTP for dosing. Staff C stated if there were multiple types of providers involved in a resident's care who disagreed on treatment, they would coordinate with the various providers directly. Staff C clarified they were not the medical director during April 2025 and had no additional information related to Resident 1's methadone order changes.Reference: (WAC) 388-97-1060 (3)(k)(iii)

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If continuation sheet

📋 Inspection Summary

AVALON CARE CENTER AT NORTHPOINTE in SPOKANE, WA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in SPOKANE, WA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from AVALON CARE CENTER AT NORTHPOINTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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