Advantage Adult Health Care II

Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were inaccessible to residents. Findings include: 1 . During an environmental inspection of the facility, the Compliance Officer observed a kitchen cabinet with locks. However, the locks were disengaged and the Compliance Officer was able to access the cabinet. The cabinet contained the following: -One container of "Member's Mark" dishwasher packs; -Two bottles of "Cascade" dishwasher detergent; and -One bottle of "Method" all-purpose cleaner. 2 . In an interview, E1 acknowledged poisonous or toxic materials stored by the assisted living facility were accessible to residents.

Based on interview and documentation review, the manager failed to ensure a therapeutic diet was provided to a resident according to a written order from the resident's primary care provider or another medical practitioner. Findings include: 1. In an interview, E2 reported R1 received tube feedings of Osmolite 1.2 250cc three times a day. 2. Review of R1's medical record revealed no order for enteral feedings. 3. In an interview, E1 acknowledged a therapeutic diet order was not available for the enteral feedings provided to R1.

Based on documentation review and interview, the manager failed to ensure the facility's disaster plan was reviewed at least once every 12 months. The deficient practice posed a risk as a disaster plan reinforces and clarifies standards expected of employees. Findings include: 1. Review of the facility's policy and procedure revealed a policy titled "Disaster plan, Relocation, Records, Medication, Food and Water." Documentation was available in the policy and procedure showing the disaster plan was last reviewed March 7, 2022. 2. In an interview, E1 acknowledged the facility's disaster plan was not reviewed within the last 12 months.

Based on observation and interview, the manager failed to ensure a rechargeable fire extinguisher was serviced at least once every 12 months. The deficient practice posed a health and safety risk to the residents if a fire extinguisher was needed and did not work properly. Findings include: 1. During an environmental inspection of the facility with E2, the Compliance Officer observed a fire extinguisher with a rating of 1A-10-BC mounted in the kitchen. This fire extinguisher had a receipt attached showing a purchase dated of August 1, 2023. A fire extinguisher with a rating of 2A-10-BC was available in the garage without a receipt or service tag attached. 2. In an interview, E2 reported the fire extinguisher with the 2A-10-BC rating was the old fire extinguisher. E1 acknowledged the rechargeable fire extinguisher was not serviced at least once every 12 months.

Based on observation, interview, and record review, the manager failed to ensure the premises were free from a condition or situation that may cause a resident or other individual to suffer physical injury. The deficient practice posed potential dangers to the resident. Findings include: 1. During an environmental inspection of the facility with E1, the Compliance Officer observed R1 lying in bed. R1's bed had full bedrails. 2. In an interview, E2 reported the bedrails were placed in the upright position at night to prevent R1 from failing out of the bed. E2 reported R1 could not move the rails up or down, and could not move around them. 3. Review of R1's medical record revealed a current written service plan for directed care services dated May 14, 2023. This service plan stated R1 had a diagnosis of "left sided paralyses and dementia" and was "non-ambulatory". 4. In an interview, E1 reported R1 moved around in the bed and acknowledged the situation may cause the resident to suffer physical injury.