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F0725
E

Insufficient Staffing Leads to Delays in ADL and Restorative Care

Spokane Valley, Washington Survey Completed on 11-24-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide sufficient nursing staff to meet the care needs of residents, specifically in the areas of activities of daily living (ADLs) and restorative nursing services. Multiple residents reported frequent delays in receiving assistance, including waiting extended periods for help with toileting and bathing. During a Resident Council meeting, all attendees stated they often had to wait a long time for care due to inadequate staffing, with some residents reporting missed showers for days or even weeks. One resident described using their cell phone to call the facility for help when their call light was not answered, and still experienced significant delays. Observations and interviews confirmed that residents were left waiting for basic care, such as being assisted off a bedpan or to the bathroom, and some residents were not receiving restorative programs for conditions like hand contractures. Staff interviews revealed that the facility had attempted to reassign duties among nursing assistants to address bathing needs, but this approach was ineffective and led to further staffing challenges. Staff members, including the Human Resource Director and LPNs, acknowledged that there were not enough nursing assistants to consistently complete showers and restorative services. The staffing coordinator confirmed that restorative aides were sometimes pulled to work the floor, resulting in restorative services not being provided. Facility leadership stated that staffing was based on resident census and state minimum requirements, but acknowledged issues with residents not being bathed. The deficiency was attributed to insufficient staffing rather than staff unwillingness to perform care.

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