Federal inspection record · CMS data as of October 1, 2026
Royal Plaza Health and Rehabilitation of Cascadia
2930 Juniper Drive, Lewiston, ID · (208) 746-2855
- Certified beds
- 78
- Residents per day
- 70
- Ownership
- For-Profit
- Chain
- Cascadia Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- December 1, 1993
1
How this home got 2 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Idaho.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Idaho homes
Royal Plaza Health and Rehabilitation of Cascadia carries 70 inspection points. That is fewer than 33% of Idaho's 79 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Idaho: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–30.5 pts
- 4★ 30.5–46 pts
- 3★ 46–63 pts
- 2★ 63–85 pts
- 1★ over 85 pts
Bars show every rated home in Idaho by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
25 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Rights7E
- E
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- D
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- E
Honor the resident's right to organize and participate in resident/family groups in the facility.
- E
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
- D
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- D
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Assessment and Care Planning5D
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care3D
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Pharmacy Service3D
- D
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- D
Ensure that residents are free from significant medication errors.
- D
Ensure that residents are free from significant medication errors.
Nutrition and Dietary2F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control2D
- D
Provide and implement an infection prevention and control program.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Administration1E
- E
Provide a neutral and fair arbitration process and agree to arbitrator and venue.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Environmental1E
- E
Keep all essential equipment working safely.
Inspection history
2026-06-26
12 health deficiencies · 2 fire-safety deficiencies
Top issue: Infection Control (2 deficiencies)
2025-04-17
3 health deficiencies · 5 fire-safety deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
2024-11-08
10 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Rights (5 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 25 min of nursing staff time a day, 58 min of it from a registered nurse.
This home
3 h 25 min
Idaho average
3 h 59 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 59% of nursing staff and 40% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.5 pts better | 0.5 | 1.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident daysAbout the same | 1.5 | 1.5 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine6.2 pts worse | 91.6% | 97.8% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.2 pts better | 98.4% | 96.2% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.9 pts worse | 4.0% | 3.1% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms7.1 pts better | 8.6% | 15.7% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.7 pts worse | 8.8% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.5 pts better | 12.9% | 16.4% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication4.6 pts worse | 24.9% | 20.3% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened5 pts worse | 20.8% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased8 pts worse | 23.4% | 15.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder1 pts better | 0.0% | 1.0% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection3 pts worse | 5.0% | 2.0% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence10.2 pts worse | 31.4% | 21.2% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.9 pts better | 1.5% | 3.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine0.5 pts better | 92.3% | 91.8% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.4 pts better | 11.5% | 11.9% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.3 pts worse | 3.0% | 1.7% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine1 pts worse | 84.4% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission3.1 pts better | 14.2% | 17.3% | 23.4% |
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Who owns and runs it
22 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Cascadia Hc Group LLC | Indirect Ownership Interest · Organization | 0% | 42 facilities |
| Cascadia Hc Group LLC | Operational/Managerial Control · Organization | 0% | 42 facilities |
| Cascadia Healthcare LLC | Indirect Ownership Interest · Organization | 0% | 42 facilities |
| Cascadia Healthcare LLC | Operational/Managerial Control · Organization | 0% | 42 facilities |
| Cascadia Holdco LLC | Indirect Ownership Interest · Organization | 0% | 41 facilities |
| Cascadia Holdco LLC | Operational/Managerial Control · Organization | 0% | 41 facilities |
| Cascadia Idaho Operations LLC | Direct Ownership Interest · Organization | 0% | 17 facilities |
| Cascadia Services LLC | Operational/Managerial Control · Organization | 0% | 47 facilities |
| Cascadia Services LLC | Adp Of The SNF · Organization | 0% | 47 facilities |
| Flemming, Thomas | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Flemming, Thomas | Adp Of The SNF · Individual | 0% | 1 facilities |
| Hammond, Owen | Indirect Ownership Interest · Individual | 0% | 46 facilities |
| Hammond, Owen | Operational/Managerial Control · Individual | 0% | 46 facilities |
| Laforte, Stephen | Indirect Ownership Interest · Individual | 0% | 42 facilities |
| Laforte, Stephen | Operational/Managerial Control · Individual | 0% | 42 facilities |
| Nelson, Timothy | Indirect Ownership Interest · Individual | 0% | 46 facilities |
| Nelson, Timothy | Operational/Managerial Control · Individual | 0% | 46 facilities |
| Rudolph, John | Operational/Managerial Control · Individual | 0% | 6 facilities |
| Rudolph, John | Adp Of The SNF · Individual | 0% | 6 facilities |
| Timberline Ohi Tenant LLC | 5% Or Greater Security Interest · Organization | 0% | 10 facilities |
| Timberline Ohi Tenant LLC | Adp Of The SNF · Organization | 0% | 10 facilities |
| White Oak Healthcare Finance LLC | 5% Or Greater Security Interest · Organization | 0% | 48 facilities |
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Fire safety
7 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Emergency Preparedness3F
- F
Conduct testing and exercise requirements.
- E
Establish emergency prep training and testing.
- E
Establish staff and initial training requirements.
Gas, Vacuum, and Electrical Systems2D
- D
Have generator or other power source capable of supplying service within 10 seconds.
- D
Have proper fire barriers, ventilation and signs for the transfilling of oxygen.
Smoke1E
- E
Inspect, test, and maintain automatic sprinkler systems.
Egress1D
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
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Other homes nearby
-
Cascadia of Lewiston
Lewiston, ID · Cascadia Healthcare
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 19 min
- Fines
- $0
-
Lewiston Transitional Care of Cascadia
Lewiston, ID · Cascadia Healthcare
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 19 min
- Fines
- $0
-
Life Care Center of Lewiston
Lewiston, ID · Life Care Centers Of America
★★★★★- Worst citation, 3 yrs
- D
- Nursing / resident / day
- 3 h 44 min
- Fines
- $0