Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Columbia Basin Care Facility during CMS and state inspections, most recent first.
The facility failed to store and handle food properly, risking cross-contamination. Raw meat was stored above eggs, and scoops were improperly placed in food bins. A dietary cook used the same gloves for different tasks without changing them, and unlabeled drinks were found in a refrigerator, violating food safety protocols.
A Gerontology Nurse Practitioner failed to adequately document the evaluation of care for three residents with chronic conditions during scheduled visits. The documentation lacked evidence of comprehensive assessments, and the practitioner was unsure of where the records were stored in the electronic health system. The facility's administration acknowledged the notes were not comprehensive.
The facility did not ensure accurate Direct Care Staff Daily Report (DCSDR) postings for 16 out of 27 days, leading to potential misinformation for residents and visitors. The Staffing Coordinator admitted to not understanding how to complete the DCSDR and failed to update it with schedule changes, while the Administrator expected accuracy in these reports.
The facility failed to implement Enhanced Barrier Precautions and ensure proper PPE use for residents, leading to potential infection risks. A resident with pneumonia had inconsistent PPE use by staff, while another with a leg wound did not have staff wearing gowns during care. Additionally, improper PPE disposal and lack of precautions for a resident with a catheter were observed, indicating systemic issues in infection control protocols.
A resident with severe cognitive impairment was physically abused by another resident with moderate cognitive impairment and a history of behavioral issues. The incident occurred when the aggressive resident, confused and agitated, believed their wheelchair was being interfered with and responded by hitting the other resident. Staff noted the aggressive resident's pattern of anger and witnessed the altercation, which resulted in a small injury to the victim.
A facility failed to maintain a resident's wheelchair in good repair, resulting in torn and cracked armrests with sharp edges. The resident, who used the wheelchair daily, found the armrests uncomfortable. Despite protocols for reporting and inspecting equipment, staff did not notice or report the disrepair.
A facility failed to conduct a significant change MDS assessment for a resident who experienced a seizure, cognitive decline, and behavioral issues. Despite these changes, no assessment was documented, and staff confirmed the oversight.
A facility failed to complete a PASARR I screening before admitting a resident with multiple sclerosis and major depressive disorder. The resident, who required substantial assistance with ADLs, was admitted without the necessary screening, which was not added to their health record even after a month. This oversight risked inappropriate placement and lack of needed services.
A resident without a documented history of epilepsy was prescribed an anticonvulsant after experiencing seizures following the administration of an antipsychotic. The facility's records did not reflect a seizure disorder diagnosis, and staff interviews revealed uncertainty about the cause of the seizures, suggesting potential links to recent infections. The facility acknowledged a lapse in consulting with a physician regarding the epilepsy diagnosis.
A resident with a self-care deficit due to a stroke and chronic pain did not receive necessary assistance with ADLs, as documented in their care plan. Observations showed a persistent brown stain on the resident's face, which staff confirmed. The facility's leadership acknowledged the expectation for staff to clean the resident's face, highlighting a failure to meet the resident's care needs.
A resident with a history of falls and multiple diagnoses, including dementia, was not provided with a fall mat as required by their care plan. Despite the care plan's directive, observations showed the mat was missing, and staff were unaware of this requirement. This oversight placed the resident at risk for injury.
A facility failed to obtain a physician order and provide timely PICC dressing care for a resident admitted with a lung abscess and pneumonia. The resident's PICC dressing was not changed for 12 days, contrary to the facility's protocol requiring changes every seven days. A nurse confirmed the oversight and lack of documentation.
A facility failed to ensure a resident, admitted with a stroke and chronic pain, was seen by a physician. A review of the resident's clinical record showed no documented physician visits since admission, confirmed by the Administrator and Social Services Supervisor.
A resident admitted with a pelvis fracture did not receive prescribed medications for five days due to unavailability. The CMA did not contact the pharmacy or notify the physician, and the RNCM was unaware of the issue, expecting staff to address medication unavailability within one day.
A facility did not follow pharmacy recommendations for a resident's trazodone prescription, which was intended to treat insomnia. The pharmacist advised separating the scheduled and PRN portions of the order for proper charting, but the June and July MARs showed the order continued unchanged. The recommendations were not fully implemented until mid-July.
A facility failed to monitor psychotropic medications for a resident, risking ineffective medication management. The resident, with insomnia, depression, and pain, was prescribed fluoxetine, trazodone, and olanzapine. The care plan required monitoring side effects and effectiveness every shift, but no documentation was found. Staff noted that a system switch led to the omission of monitoring, which was not corrected despite management being informed. This was confirmed by the administrator and social services supervisor.
Food Storage and Handling Deficiencies
Penalty
Summary
The facility failed to store and handle food properly, leading to potential cross-contamination risks. During an inspection, raw meat was found stored on a wire rack shelf directly above eggs and cartons of liquid whole eggs in the walk-in refrigerator, which could lead to dripping and contamination. Additionally, plastic-handled scoops were stored in direct contact with food items such as brown sugar, powdered sugar, white sugar, and dry pasta, increasing the risk of cross-contamination. The Food Service Director acknowledged these issues, attributing them to staff negligence. Further observations revealed improper food handling practices by staff. A dietary cook used the same gloved hand to open an oven door and then handle a dinner roll, which was placed on a resident's lunch plate without changing gloves, creating an opportunity for cross-contamination. Additionally, two unlabeled plastic mugs containing a brown thickened liquid were found in a snack refrigerator, lacking proper labeling and dating as required by the US FDA 2022 Food Code. The Food Service Director was unaware of who placed the mugs in the refrigerator, highlighting a lapse in adherence to food safety protocols.
Inadequate Documentation of Resident Care by Provider
Penalty
Summary
The facility failed to ensure that the total program of care for three residents was adequately reviewed and documented during provider visits. Resident 4, who was admitted in 2020 with a diagnosis of neuralgia, had provider visits in March, May, and July 2024 conducted by a Gerontology Nurse Practitioner, Staff 29. However, the documentation from these visits lacked sufficient evidence that the resident's condition and total program of care were evaluated. Staff 29 admitted uncertainty about where the documentation was recorded in the electronic health record and could not provide additional information regarding her evaluations. Similarly, Resident 21, admitted in February 2023 with chronic pain and dementia, and Resident 23, admitted in May 2019 with dementia and hypertension, also had provider visit notes that were insufficient in documenting evaluations of their conditions and total programs of care. Staff 29 conducted these visits but again failed to provide comprehensive documentation. The facility's Administrator and Director of Nursing Services reviewed the notes and acknowledged that they were not comprehensive, indicating a systemic issue with documentation during provider visits.
Inaccurate Staffing Reports
Penalty
Summary
The facility failed to ensure the accuracy of the Direct Care Staff Daily Report (DCSDR) postings for 16 out of 27 days reviewed, which could lead to residents and visitors receiving inaccurate staffing information. The review of the DCSDR from August 1 to August 27, 2024, revealed discrepancies in the reported hours worked by Certified Nursing Assistants (CNAs) and Nursing Assistants (NAs) on specific dates. On August 29, 2024, the Staffing Coordinator (Staff 17) admitted to not fully understanding how to complete the DCSDR and failing to update the report to reflect schedule changes. The Administrator (Staff 1) expected the DCSDR to be accurate, indicating a lack of proper training or oversight in maintaining accurate staffing records.
Failure to Implement Enhanced Barrier Precautions and PPE Use
Penalty
Summary
The facility failed to implement appropriate Enhanced Barrier Precautions (EBP) and ensure the correct use of personal protective equipment (PPE) for three residents, leading to a risk of infection spread. Resident 146, admitted with an abscess of the lung and pneumonia, had Contact Precautions signage posted, but staff were observed entering the room without donning PPE. Staff expressed confusion about the required precautions, and the resident confirmed inconsistent PPE use by staff. Similarly, Resident 43, with an infected leg wound, did not have staff consistently wearing gowns during wound care, despite the presence of PPE containers outside the room. The Infection Preventionist was unaware of the gown requirement for EBP, indicating a lack of proper training and communication. Additionally, the facility's infection control practices were inadequate, as observed with the improper disposal of used PPE and the absence of a disposal container in one room. Resident 296, with an indwelling catheter, was not placed on EBP, contrary to the requirements. Staff confirmed the oversight, highlighting a systemic issue in the facility's infection control protocols. These deficiencies demonstrate a failure to adhere to established guidelines for preventing infection transmission, putting residents at risk.
Failure to Protect Resident from Physical Abuse
Penalty
Summary
The facility failed to protect a resident's right to be free from physical abuse, as evidenced by an incident involving two residents. Resident 16, who was admitted with a severe cognitive impairment, was physically abused by Resident 13, who has moderate cognitive impairment and a history of behavioral issues. On the day of the incident, Resident 13, who was confused and agitated, believed that Resident 16 was interfering with their wheelchair and responded by hitting Resident 16 in the face, causing a small open area. Staff members witnessed the altercation and noted that Resident 13 was having a particularly bad day, exhibiting aggressive behavior towards both residents and staff. Interviews with staff and residents revealed that Resident 13 had a pattern of becoming angry without apparent reason, and on this occasion, they verbally and physically lashed out. Despite the incident, Resident 16 later reported feeling safe in the facility, although initially uncomfortable around Resident 13. The facility's investigation confirmed the altercation and the inappropriate behavior of Resident 13, highlighting a failure to adequately protect Resident 16 from abuse.
Failure to Maintain Resident Care Equipment
Penalty
Summary
The facility failed to ensure that resident care equipment was in good repair, specifically for a resident with multiple sclerosis who was cognitively intact and used a wheelchair. Observations over several days revealed that the resident's wheelchair had torn and cracked vinyl coverings on both armrests, with sharp, rough edges protruding. The resident reported using the wheelchair daily and described the armrests as uncomfortable and rough on their skin. Despite the facility's protocol for staff to report equipment in disrepair to maintenance and conduct nightly wheelchair inspections, the issues with the wheelchair were not noticed or reported by the staff responsible for the resident's care.
Failure to Conduct Significant Change MDS Assessment
Penalty
Summary
The facility failed to document and conduct a significant change Minimum Data Set (MDS) assessment for a resident who experienced notable changes in condition. The resident was admitted with diagnoses including stroke and depression and initially assessed as cognitively intact with a BIMS score of 14. Over time, the resident's condition changed significantly, including a seizure event and a new prescription for topiramate for epilepsy. Additionally, the resident was involved in a physical altercation with another resident and exhibited behavioral changes, such as increased cognitive impairment and incontinence, as noted in a subsequent quarterly MDS. Despite these significant changes, no significant change assessment was found in the resident's clinical record. Interviews with staff revealed that the resident exhibited behaviors such as verbal abuse and physical aggression, particularly after family visits. The facility's administrator and interim Director of Nursing Services confirmed that a significant change MDS should have been completed, indicating a lapse in the facility's assessment and documentation processes.
Failure to Complete PASARR I Screening Prior to Admission
Penalty
Summary
The facility failed to complete a PASARR I (Pre-Admission Screening/Resident Review) screening prior to the admission of a resident diagnosed with multiple sclerosis and major depressive disorder. This resident, who was cognitively intact and required substantial assistance with activities of daily living, was admitted in July 2024. Upon review, no evidence was found in the resident's health record to indicate that the PASARR I was completed before admission. The Social Services Director confirmed that the PASARR I was not added to the resident's electronic health record, despite the resident being in the facility for over a month. This oversight placed the resident at risk for inappropriate placement and lack of needed services.
Failure to Follow Professional Standards in Medication Management
Penalty
Summary
Facility staff failed to adhere to professional standards of practice regarding the diagnosis and treatment of a resident's condition. The resident, admitted with diagnoses including stroke and depression, did not have a documented history of seizure disorder or epilepsy. Despite this, the resident was prescribed topiramate, an anticonvulsant, following a seizure episode after starting olanzapine, an antipsychotic medication. The resident experienced multiple seizures and was later hospitalized for sepsis due to a UTI. The facility's records, including the comprehensive care plan and MDS assessments, did not reflect a diagnosis of seizure disorder or epilepsy, raising concerns about the appropriateness of the anticonvulsant prescription. Interviews with facility staff revealed uncertainty about the cause of the seizures, with a pharmacist consultant suggesting that the seizures could have been related to the resident's recent COVID-19 infection or sepsis. The resident reported experiencing muscle cramps that appeared as convulsions when not administered gabapentin timely. The facility's administrator and interim DNS acknowledged that the nurse practitioner should have consulted with the physician regarding the epilepsy diagnosis, indicating a lapse in communication and coordination of care for the resident.
Failure to Assist Resident with ADLs
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for a resident who was dependent on staff for personal care. Resident 13, admitted in November 2023 with a history of stroke and chronic pain, had a care plan indicating a self-care deficit requiring substantial assistance with ADLs, including grooming. However, a review of the Documentation Survey Report on August 26, 2024, showed no records of personal hygiene care being provided to the resident during the day or evening shifts. Observations on multiple occasions revealed a brown stain on the resident's face, which was confirmed by staff. The facility's administrator and interim director of nursing services acknowledged that staff were expected to clean the resident's face, indicating a lapse in meeting the resident's care needs.
Failure to Implement Fall Prevention Measures
Penalty
Summary
The facility failed to implement care plan interventions for a resident at risk for falls, leading to a deficiency. The resident, admitted in May 2019, had a history of a fall and was diagnosed with a fracture of the left lower leg, dementia, and high blood pressure. The resident's care plan, updated in March 2024, identified the risk for falls and included an intervention to place a fall mat at the side of the bed, revised in April 2024. However, observations in August 2024 revealed that the fall mat was not placed at the bedside as required by the care plan. Staff members, including CNAs and an RNCM, were unaware of the requirement for a fall mat, despite it being documented in the care plan. The RNCM confirmed the absence of the fall mat, acknowledging the oversight in implementing the care plan intervention, which placed the resident at risk for injury.
Failure to Provide Timely PICC Dressing Care
Penalty
Summary
The facility failed to obtain a physician order and provide appropriate PICC dressing care for a resident, identified as Resident 146, who was admitted with a lung abscess and pneumonia. The resident's admission orders included central venous access care per facility protocol, but there was no physician order or resident-specific protocol documented for PICC dressing care. During the period from admission to 12 days later, there was no documentation indicating that the PICC dressing care was provided. On observation, the resident's PICC dressing was found to have been changed on the 12th day after admission, with the resident confirming that it had not been changed since admission. A registered nurse (RN) acknowledged changing the dressing on that day after noticing it had not been changed since admission and confirmed the lack of documentation and physician order. Another RN confirmed that the facility protocol required PICC dressings to be changed every seven days, which was not adhered to in this case.
Failure to Ensure Physician Visits for Resident
Penalty
Summary
The facility failed to ensure that a resident was seen by a physician, which was identified during a survey. The deficiency involved a resident who was admitted to the facility with diagnoses including a stroke and chronic pain. A review of the resident's clinical record revealed that there were no documented physician visits since the resident's admission. This was confirmed by the facility's Administrator and Social Services Supervisor during an interview.
Failure to Provide Prescribed Medications
Penalty
Summary
The facility failed to provide prescribed medications for one of the sampled residents, identified as Resident 147, who was admitted with a pelvis fracture. The physician's orders dated 8/22/24 included Preservision AREDs 2, psyllium oral capsules, and tolterodine tartrate, which were not available from 8/22/24 to 8/26/24. Staff 7, a CMA, confirmed that the medications were marked as unavailable on the MAR and admitted to not contacting the pharmacy or notifying the physician about the unavailability for five days. Staff 12, an RNCM, stated that medications should be available upon admission and that staff should check the cubex or contact the pharmacy if medications are unavailable. However, Staff 12 was unaware of the issue and expected staff to notify the pharmacy and physician within one day of recognizing the unavailability.
Failure to Implement Pharmacy Recommendations for Medication Order
Penalty
Summary
The facility failed to follow up on pharmacy recommendations for a resident admitted with insomnia. The resident was prescribed trazodone at bedtime for insomnia, with an additional tablet if not asleep within an hour. The pharmacist recommended discontinuing the current trazodone order and re-entering it with scheduled and PRN portions separated for proper administration charting. However, the June 2024 Medication Administration Record (MAR) showed that the trazodone order continued as previously prescribed, and the pharmacist's recommendations were not implemented. In July 2024, the pharmacist reiterated the same recommendation, and a handwritten note indicated it was done on July 15, 2024. Despite this, the July 2024 MAR revealed that the trazodone order remained unchanged until July 16, 2024, when it was added to the PRN section, indicating that the pharmacist's recommendations were not fully implemented.
Failure to Monitor Psychotropic Medications
Penalty
Summary
The facility failed to adequately monitor psychotropic medications for a resident, which placed them at risk for ineffective medication management. The resident was admitted with diagnoses including insomnia, depression, and pain, and was prescribed fluoxetine, trazodone, and olanzapine. The care plan required monitoring and documenting the side effects and effectiveness of these medications every shift. However, there was no documentation in the resident's clinical record to indicate that this monitoring occurred. Staff reported that when the facility switched systems for tracking clinical records, the monitoring of side effects was not included, and despite notifying management, it was not added. This lack of monitoring was confirmed by the facility's administrator and social services supervisor.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near The Dalles
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Dalles Health And Rehabilitation | 0.9 mi | — | 1 | 0 |
| Oregon Veterans Home | 3.9 mi | — | 0 | 0 |
| Hood River Post Acute | 17.2 mi | — | 10 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.