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Nursing HomeMedicaid Investigative

Paradise Creek Health and Rehab of Cascadia

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

640 North Eisenhower Street, Moscow, ID 8384363 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
3.4/5

based on 10 Google reviews

5
4
3
2
1

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5/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Low staffing rating (2/5 stars)
  • High staff turnover (69%)
  • High RN turnover (62%)

Below average in ID · Below recommended RN staffing · Below chain average · $90,362 in fines

Source: Medicare data

What this means for your family

While the rehab staff receives praise for their bedside manner, the facility has significant issues with administrative oversight and resident treatment. Families should be extremely cautious and verify that management has a reliable system for medication orders before choosing this facility for end-of-life or high-acuity care.

Google Reviews

Google Reviews

10 reviews on Google
Paradise Creek shows a stark divide between its independent retirement living and its skilled nursing/rehab services. While some residents praise the community atmosphere and staff friendliness, others report serious concerns regarding management incompetence, particularly in medication administration and the treatment of residents in the nursing wing.

Quality Themes

Tap a score for details
Food2.0Staff5.0Clean7.0ActivitiesN/AMeds1.0MemoryN/AComms2.0ValueN/A

Strengths

  • Friendly and attentive nursing staff
  • Clean and well-maintained environment
  • Supportive atmosphere for independent living

Concerns

  • Management incompetence regarding medication orders and end-of-life care (mentioned by 2 reviewers)
  • Lack of compassion and poor treatment of residents by staff (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

2345.02020(2)1.02021(1)3.02024(2)3.02025(4)5.02026(2)

Distribution · 11 analyzed

5
6
4
0
3
2
2
0
1
3

How They Respond to Reviews

50%response rate

This facility responds to some reviews.

Questions for Your Tour

  • 1Given that medication management is a top priority for our family, could you walk us through your specific process for ensuring accuracy and preventing errors in prescription orders?
  • 2How does your leadership team ensure that staff maintain a compassionate and patient-centered approach when providing daily care to residents?
  • 3I noticed the facility has a smaller capacity of 63 residents; how does this size influence the way you communicate with families regarding changes in a resident's health status?
  • 4Could you share how you are working to improve the dining experience and meal variety for residents, as we understand this is an area you are currently focusing on?
  • 5In the event of an urgent medical need or end-of-life care, what is your protocol for coordinating with families to ensure their wishes are honored and clearly communicated?
  • 6I see that you actively respond to feedback online; how do you incorporate that family input into your daily operations and staff training?

Personalized based on this facility's data


Key Review Excerpts

The nursing staff in the skilled nursing part of the facility was wonderful in my husband's last days, but the management is terrible. Hospice faxed over orders for end of life medications to manage pain, anxiety, and nausea and vomiting, as per hospice protocol. The manager didn't bother to enter the orders into the computer.

Long-term resident's family · 2024☆☆☆☆

We have had an outstanding experience in the skilled nursing/rehab portion of this facility. The staff are consistently friendly and attentive.

Rehab patient family member · 2024★★★★★

My eldest sister lives there and says the staff in this place "turn a blind eye"/"condone by their silence" the acts of co-workers mistreating the residents that don't want to wake up in the morning

Long-term resident's family · 2025★★★☆☆
Source: 10 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.52hrs
70%
Registered nurses for medical care
Total Nursing
3.33hrs
81%
All nurses + aides combined
Staff Turnover
65%
Lower is better (< 30% = good)
RN Turnover
46%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
3/ 5
Better Than Avg

7

measures

Worse Than Avg

9

measures

Similar to Avg

1

measures

Long-Stay Residents
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility57.1%
Worse than Avg
Here
57.1%
US
95.5%
ID
96.2%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility69.6%
Worse than Avg
Here
69.6%
US
93.4%
ID
96.9%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility6.0%
Better than Avg
Here
6.0%
US
19.5%
ID
16.3%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility28.3%
Worse than Avg
Here
28.3%
US
19.4%
ID
22.6%
😔

Residents with depression symptoms

↓ Lower is better
This Facility6.4%
Better than Avg
Here
6.4%
US
12.1%
ID
14.4%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💊

Residents on antipsychotic medication

↓ Lower is better
This Facility12.8%
Better than Avg
Here
12.8%
US
15.5%
ID
20.1%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility34.6%
Worse than Avg
Here
34.6%
US
79.8%
ID
86.5%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility39.7%
Worse than Avg
Here
39.7%
US
81.8%
ID
90.6%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.9%
Worse than Avg
Here
1.9%
US
1.6%
ID
1.7%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

3deficiencies
12penalties
Well below state avg (8.8)
16 complaint-triggered
$90,362 in fines

This facility shows concerning patterns with families filing complaints that led to deficiencies in abuse protection, resident rights, and care quality in 2023. The most recurring issues involve food safety and preparation, infection control, and safety hazards, with problems appearing across multiple surveys from 2020 through 2024. While all deficiencies show correction dates, the persistence of similar issues across years suggests ongoing challenges with maintaining consistent standards.

May 7, 2026Routine
3
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0692Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

Aug 29, 2024Routine
12
0684Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0730Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Observe each nurse aide's job performance and give regular training.

0804Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

0585Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0756Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

0100Potential for harm · IsolatedCorrected

Construction Deficiencies

Meet other general requirements.

0321Potential for harm · IsolatedCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0345Potential for harm · IsolatedCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0511Potential for harm · IsolatedCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0923Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper medical gas storage and administration areas.

Jul 14, 2023Routine
5
0914Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

0883Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Develop and implement policies and procedures for flu and pneumonia vaccinations.

0324Potential for harm · IsolatedCorrected

Smoke Deficiencies

Provide properly protected cooking facilities.

0345Potential for harm · IsolatedCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0511Potential for harm · IsolatedCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

Jul 14, 2023Complaint
16
0600Actual harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

0689Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0880Potential for harm · WidespreadCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0565Potential for harm · PatternCorrected

Resident Rights Deficiencies

Honor the resident's right to organize and participate in resident/family groups in the facility.

0684Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0558Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0578Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0610Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0848Potential for harm · IsolatedCorrected

Administration Deficiencies

Provide a neutral and fair arbitration process and agree to arbitrator and venue.

0882Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Federal Penalties

Fine

Aug 29, 2024

$21,320

Fine

Sep 25, 2023

$4,587

Fine

Sep 18, 2023

$4,587

Fine

Sep 11, 2023

$4,545

Fine

Sep 5, 2023

$4,587

Fine

Aug 28, 2023

$4,587

Fine

Aug 21, 2023

$4,545

Fine

Aug 14, 2023

$4,587

Fine

Jul 17, 2023

$10,489

Fine

Jul 14, 2023

$18,084

Fine

Jun 26, 2023

$2,823

Fine

Jun 20, 2023

$2,447

Ownership & Operations

Who Operates This Facility

Owner / Operator

Paradise Creek Health and Rehab of Cascadia

Organization Type

for profit

Chain Affiliation

Chain Name

Cascadia Healthcare

Chain Size

44 facilities nationwide

Chain avg rating: 3.2/5 · Rank 32 of 43

Ownership & Management

Key personnel

Moscow 640 Realty, LLC5% or Greater Security InterestWhite Oak Healthcare Finance LLC5% or Greater Security InterestCascadia Services LLCManagerBong, DanielManagerHammond, OwenManager
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 1 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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