Royal Park Health And Rehabilitation
Inspection Findings
F-Tag F0755
F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Note: The nursing home is disputing this citation.
FORM CMS-2567 (02/99) Previous Versions Obsolete
Setting, Copyright 2021, indicates on page 63, that opioid dependence (i.e., the body's physical dependence on opioids to function normally) is common. A withdrawal syndrome can result from abrupt cessation, rapid dose reduction.During an interview with Resident 1 on 09/09/2025 at 11:50 PM, with their spouse also present in the room, Resident 1 stated that there was a day, last month, when I did not get my Morphine in the evening or the next day. They further stated that they had been on the same dose of Morphine for several years, related to chronic pain, and were dependent on the medication for pain relief.
They stated that when they did not get the Morphine in the evening the nurse told them that the medication had not come from the pharmacy, and it would come the next day. On the next day it still did not come, and
the nurse told them that they would get their as needed Hydrocodone (a narcotic mixed with Tylenol) until
the Morphine arrived. They stated that they went through that day and experienced unrelieved pain and felt that they experienced withdrawal symptoms in the form of body aches and flu-like symptoms until the medication arrived from the pharmacy the next day. They further stated that they did not feel as if the nursing staff took the situation seriously and discounted their complaints of pain and withdrawal.In an
interview on 09/09/2025 at 1:14 PM with Staff B, Resident Care Manager (RCM) and LPN, they stated that
the facility policy for reordering medication was for the nurse to notify the pharmacy when there was a seven-day supply of the medication remaining. They further stated that if the floor nurse did not have an ordered medication for a resident, they should notify them so they could communicate with the medical provider. They further stated that they were the RCM responsible for oversight for Resident 1 and they had no knowledge of the resident missing their prescribed twice daily Morphine.In an interview with Staff A, Director of Nursing, on 09/09/2025 at 1:40 PM, they stated that the facility policy for reordering medications was for the nurse to notify the pharmacy when there was a three-day supply of the resident's medication remaining. They stated that if a medication was reordered too soon the pharmacy would not send it. They further stated that they had no awareness of Resident 1 having missed doses of their prescribed Morphine.
In a later communication via email, on 09/11/2025 at 3:16 PM, Staff A stated that the nurse was to reorder
the resident medication when the resident supply hit the blue line on the medication card, indicating the last seven doses of the medication were remaining.During an e-mail conversation with Staff C, Nurse Practitioner, on 09/11/2025 at 10:15 AM, they wrote that, this situation of not having the morphine was not planned or recommended. Later in the same email chain, at 10:31 AM, Staff C indicated that Resident 1 was very aware of [their] pain management and all of the medications included in [their] pain management plan. Staff C further stated that they did not speak with Resident 1 about their prescribed Morphine not being available nor had they written a progress note related to the situation.In an interview with Staff D, LPN, on 09/09/2024 at 2:48 PM, they stated that they had verbally spoken to the Medical Provider, Staff C,
on the same day Resident 1 was out of their prescribed Morphine. They further stated that they had not noticed Resident 1 was almost out of their Morphine until the day before they ran out and Staff D thought
they had communicated with Staff C then too but could not remember clearly. They stated that the medication should have been reordered when the remaining supply was at the blue line, with seven days of
the medication remaining. They stated that during the time Resident 1's Morphine was not available that Resident 1 had asked them several times when it was coming from the pharmacy and indicated that they wanted the medication. Reference: (WAC) 388-97-1300 (1)(a)(b)(i)(ii)
Event ID:
Facility ID:
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Royal Park Health and Rehabilitation in SPOKANE, WA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 Royal Park Health and Rehabilitation or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.