Royal Park Health And Rehabilitation
Royal Park Health and Rehabilitation in SPOKANE, WA — inspection on September 9, 2025.
Found 1 citation. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
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)
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