Map showing the location of ROYAL PLAZA HEALTH AND REHABILITATION OF CASCADIA in LEWISTON, Idaho
2870 JUNIPER DRIVE, LEWISTON, ID, 83501

Overall Score

CMS Five-Star Quality Rating
4/5Above averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • IdahoAbove 59% of peers79 rated homes · average 3.2★
  • Nez Perce CountyAbove only 40% of peers6 rated homes · average 3.7★
  • United StatesAbove 61% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point4★+1.3 vs ID avg
  • StaffingCan add or remove a star4★+0.9 vs ID avg
  • Quality measuresCan add or remove a star3★−1.2 vs ID avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles4★Above 68% of peersID avg2.7★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover4★Above 60% of peersID avg3.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments3★Above only 9% of peersID avg4.2★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.71hrsAbove only 35% of peersID avg4.07Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.97hrsAbove 65% of peersID avg0.83Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better42%Above 70% of peersID avg49%RN turnover31%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$0Above only 35% of peersID avg$14,059Fines · denials0 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
27citations
3inspection dates
3actual harm (G–I)
2immediate jeopardy (J–L)
Apr 17, 2025most recent

Citations by monthJul 2021 – Apr 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Apr 17, 20253 citationsCycle 1worst F · no actual harm
  1. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected May 19, 2025
  2. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected May 19, 2025
  3. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected May 19, 2025
Nov 8, 202410 citationsCycle 2worst E · no actual harm
  1. F585Honor 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.Resident RightsE · patternCorrected Dec 13, 2024
  2. F622Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.Resident RightsD · isolatedCorrected Dec 13, 2024
  3. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected Dec 13, 2024
  4. F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.Resident Assessment and Care PlanningD · isolatedCorrected Dec 13, 2024
  5. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Dec 13, 2024
  6. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Dec 13, 2024
  7. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected Dec 13, 2024
  8. F908Keep all essential equipment working safely.EnvironmentalE · patternCorrected Dec 13, 2024
  9. 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 RightsD · isolatedCorrected Dec 13, 2024
  10. F565Honor the resident's right to organize and participate in resident/family groups in the facility.Resident RightsE · patternCorrected Dec 13, 2024
Jul 24, 202114 citationsCycle 3worst J · immediate jeopardy
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Nov 19, 2021
  2. F578Honor 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.Resident RightsE · patternCorrected Sep 20, 2021
  3. F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsD · isolatedCorrected Sep 20, 2021
  4. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Sep 20, 2021
  5. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected Sep 20, 2021
  6. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Sep 20, 2021
  7. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareG · isolatedCorrected Sep 20, 2021
  8. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareG · isolatedCorrected Sep 20, 2021
  9. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Sep 20, 2021
  10. F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.Nursing and Physician ServicesH · patternCorrected Sep 20, 2021
  11. F740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.Quality of Life and CareJ · isolatedCorrected Sep 20, 2021
  12. F744Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.Quality of Life and CareD · isolatedCorrected Sep 20, 2021
  13. F865Have a plan that describes the process for conducting QAPI and QAA activities.AdministrationF · widespreadCorrected Sep 20, 2021
  14. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Sep 20, 2021

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.71hrsAbove only 35% of peers−0.36 vs ID avg
  • Registered nursesRN hours only0.97hrsAbove 65% of peers+0.14 vs ID avg
  • Licensed practical nursesLPN hours0.54hrs
  • Nurse aidesCNA hours2.20hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.07hrs
  • Idaho average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better42%Above 70% of peersID avg 49%
  • RN turnoverRegistered nurses only31%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy76 certified beds · ~62 residents a day81%Above 65% of peersID avg 74%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $0In fines
  • 0Fines
  • 0Payment denials
  • $14,059ID avg in fines
Above only 35% of peersFewer fines than 35% of rated homes in Idaho

Actions on record

No fines or payment denialsNothing on record in the current reporting window. Idaho facilities average 0.7 penalties.

Ownership

As filed with CMS

Structure

Ownership type
For profit - Partnership
Chain
Cascadia Healthcare44 facilities in the chain3.2★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Indirect owners (5%+)
  • Cascadia Healthcare LLC
Operational or managerial control
  • Cascadia Hc Group LLC
  • Cascadia Healthcare LLC
  • Cascadia Holdco LLC
  • Cascadia Services LLC
  • Thomas Flemming
  • Owen Hammond
  • Stephen Laforte
  • Timothy Nelson
  • +1 more
5% Or Greater Security Interest
  • Timberline Ohi Tenant LLC
  • White Oak Healthcare Finance LLC

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 135116 · 2870 JUNIPER DRIVE, LEWISTON, ID, 83501.
  • Percentiles compare this facility with every rated nursing home in Idaho and Nez Perce County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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