I have not been back there since 2004, but I have heard that the ladder has been gone since 2009. There is a rope someone placed there to facilitate climbing, but I don't know if I'd trust someone else's securing of the rope as that is a long distance to fall if it let go. So unless a new ladder is erected I will probably never see the inside of this cave again.
You have to cross the river using stepping stones (you can see a couple of them in the lower right of the pic). They can be slippery and you may end up with wet feet if you slip. Once you climb the ladder, there is a rope anchored in the rocks with handhold knots to facilitate rappelling to the cave floor, and climbing back out again. It is not a huge distance to the cave floor so if the rope broke you wouldn't have too far fall.
The cave is actually a gorge, and is open at the top. In the pic below I am standing in a ray of sunlight beaming in from the gap in the ceiling.
Looking up at the ceiling of the cave.
This view is looking back out towards the mouth of the cave.
Even though there is no longer a ladder to the cave, this is still a beautiful hike and the falls are well worth the walk. There used to be a picnic table perched on a flat spot overlooking the falls, and there are outhouses along the trail as well. I am just so thankful that I had the opportunity to get into the cave before the ladder was removed.