Paradise Creek Health and Rehab of Cascadia
640 North Eisenhower Street, Moscow, ID 83843 · Latah County · 63 certified beds · avg 47 residents/day · certified since Jun 1, 1977
Part of chain: CASCADIA HEALTHCARE (46 facilities, chain avg rating 3.0★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 4/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Aug 29, 2024 · F-0684
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Sep 27, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Jul 14, 2023 · F-0600
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Aug 8, 2023 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Jul 14, 2023 · F-0689
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Aug 8, 2023 (Deficient, Provider has date of correction)
All citations in the current public record (27)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| May 7, 2026 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| May 7, 2026 | D · Potential for harm, one-off | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. |
| May 7, 2026 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Aug 29, 2024 | ▲ G · Actual harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Aug 29, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not observe each nurse aide's job performance or provide regular training as required. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Aug 29, 2024 | D · Potential for harm, one-off | The facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. |
| Aug 29, 2024 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Aug 29, 2024 | D · Potential for harm, one-off | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Jul 14, 2023 | ▲ G · Actual harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. |
| Jul 14, 2023 | ▲ G · Actual harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Jul 14, 2023 | F · Potential for harm, facility-wide | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not honor residents' right to form and take part in resident or family groups, such as a resident council. |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not provide a neutral and fair arbitration process. Arbitration is a way of settling disputes outside of court, and if it's used, the facility must agree with the resident on a neutral arbitrator and a convenient location. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not designate a qualified infection preventionist — a trained person responsible for running the infection prevention and control program. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (7 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 17 | 2 | G ▲ |
| 2024 | 7 | 1 | G ▲ |
| 2026 | 3 | 0 | F |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
7 fines totaling $48,758.
| Date | Type | Amount / length |
|---|---|---|
| Aug 29, 2024 | Fine | $21,320 |
| Sep 25, 2023 | Fine | $4,587 |
| Sep 18, 2023 | Fine | $4,587 |
| Sep 11, 2023 | Fine | $4,545 |
| Sep 5, 2023 | Fine | $4,587 |
| Aug 28, 2023 | Fine | $4,587 |
| Aug 21, 2023 | Fine | $4,545 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Idaho avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.62 | 4.03 | 3.95 | bottom 41% in Idaho; bottom 43% in the U.S. |
| Registered Nurse hours | 0.72 | 0.87 | 0.69 | top 48% in Idaho; top 34% in the U.S. |
| Weekend total nurse staffing | 3.17 | 3.48 | 3.50 | bottom 46% in Idaho; bottom 40% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.45 | 0.56 | 0.48 | bottom 39% in Idaho; top 39% in the U.S. |
| Total nursing staff turnover (%) | 70.9 | 50.3 | 45.8 | bottom 7% in Idaho; bottom 5% in the U.S. |
| RN turnover (%) | 75.0 | 41.0 | 42.9 | bottom 3% in Idaho; bottom 9% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.36, RN 0.67, weekend 2.94. Staffing rating: 2/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 3/5 · long-stay residents: 3/5 · short-stay residents: 3/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Bong, Daniel | Individual | Operational/Managerial Control | NOT APPLICABLE | 02/20/2026 |
| Bong, Daniel | Individual | ADP of the SNF | NOT APPLICABLE | 04/10/2026 |
| Cascadia Services LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 10/21/2022 |
| Cascadia Services LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/21/2022 |
| Hammond, Owen | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2023 |
| Moscow 640 Realty, LLC | Organization | 5% or Greater Security Interest | NOT APPLICABLE | 06/05/2025 |
| Moscow 640 Realty, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/05/2025 |
| Nelson, Timothy | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/05/2025 |
| Spady, Robert | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2023 |
| Spady, Robert | Individual | ADP of the SNF | NOT APPLICABLE | 02/26/2025 |
| White Oak Healthcare Finance LLC | Organization | 5% or Greater Security Interest | NOT APPLICABLE | 08/11/2022 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
- "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
- "How often do you evaluate your nurse aides and what ongoing training do they receive?"
- "Could I join residents for a meal to see the food quality and temperature for myself?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Aspen Park of Cascadia | 1.6 mi | Moscow, ID | ★★★★★ | 4/5 | |
| Three Creeks Post Acute | 10.6 mi | Pullman, WA | ★☆☆☆☆ | 1/5 |
Compare this facility with the 2 closest →
Facility data as of CMS processing date 2026-08-01. CCN 135067.