Spokane Falls Care

In the surveyor’s words

From the most serious findings on record at Spokane Falls Care, in the surveyor’s own words.

• Immediate jeopardy, widespreadF880Jan 11, 2021

  Based on interview and record review, the facility failed to maintain an infection control program that included adequate, timely surveillance, oversight, and follow up of staff COVID-19 testing. Failure to ensure all staff completed the required testing during an active COVID-19 outbreak at the facility put all residents at risk for COVID infection, when staff continued to work with unknown COVID status. On 01/08/2021 at 3:30 PM, the facility's Executive Director was notified of an Immediate Jeopardy at F880, related to lack of adequate surveillance of staff COVID-19 testing. The facility removed the immediacy on 01/11/2021 at 1:07 PM, by ensuring a surveillance system was in place and appropriate education completed, to ensure all staff were being tested appropriately. […]

• Immediate jeopardy, patternF886Jan 11, 2021

  Based on interview and record review, the facility failed to ensure staff COVID-19 testing was performed as required for eight of nine staff members (Staff C, D, E, F, G, H, I, J), reviewed for testing. This failure placed all residents at risk of COVID-19 infection, due to staff working with unknown COVID status during a COVID outbreak at the facility. On 01/08/2021 at 3:30 PM, the facility's Executive Director was notified that an Immediate Jeopardy was identified at F886, related to lack of adequate staff COVID-19 testing. The facility removed the immediacy on 01/11/2021 at 1:07 PM, by ensuring a surveillance system was in place and appropriate education completed, to ensure all staff were being tested appropriately. […]

• Actual harm, isolatedF697May 13, 2025

  Based on observation, interview, and record review, the facility failed to provide necessary pain management for 2 of 3 sampled residents (Resident 1 and 3), reviewed for pain. Resident 1 and 3 each experienced harm when the facility did not treat their pain timely, after the residents rated their pain as a 10 (0 is no pain and 10 is the most intense pain) on admission to the facility. This failure placed residents at risk of uncontrolled pain and diminished quality of life. Findings included . <Resident 1> Review of a facility assessment, dated 04/16/2025, showed Resident 1 was admitted on [DATE] and had diagnoses which included a below the knee amputation (BKA). The resident was able to make their needs known. […]

• Actual harm, isolatedF689Mar 8, 2024

  Based on observation, interview and record review, the facility failed to ensure 2 of 4 sampled residents (Residents 4, and 5), reviewed for accidents, was free from injury. Resident 4, who had a history of seizure-like activity (spasms/involuntary jerking movements), experienced harm when they were left unsupervised in their wheelchair after a seizure-like episodes earlier that morning, fell out of their wheelchair onto the floor and sustained a neck fracture. Resident 5 experienced harm when their wheelchair was not properly secured in the facility transport van; when the van stopped to avoid an accident, the resident ' s wheelchair flipped backwards which resulted in the resident hitting their head on the back door. […]

• Actual harm, isolatedF684Nov 2, 2023

  Based on observation, interview and record review, the facility failed to provide thorough assessments and evaluate for changes in condition, for 1 of 3 residents (Resident 1), reviewed for change in condition. Failure to monitor Resident 1's right arm after complaints of pain and increased edema (swelling caused by too much fluid in the tissues)resulted in harm to Resident 1, who was sent to the hospital and diagnosed with blood clots in their right arm and lungs. Findings included . Review of a facility assessment, dated 09/11/2023, showed Resident 1 was admitted with diagnoses which included lung and heart disease. The resident was able to make their needs known. In an interview on 10/24/2023 at 9:20 AM, with collateral contact (CC). […]