Amiga 2 Assisted Living Home LLC

Based on record review and interview, the manager failed to ensure that a resident had a service plan that, when updated, was signed and dated by the resident or resident's representative, the manager, and the nurse or medical practitioner who reviewed the service plan, for three of four residents sampled. The deficient practice posed a health and safety risk if the required individual did not acknowledge the services that were to be provided. Findings include: 1. A review of R1’s medical record revealed a service plan dated June 23, 2025, for personal care services, including medication administration services. However, this service plan did not include a signature and date by the resident or the resident’s representative, or a nurse or medical practitioner. 2. A review of R3’s medical record revealed a service plan dated August 25, 2025, for directed care services, including medication administration services. However, this service plan did not include a signature and date by the resident’s representative, the manager, or a nurse or medical practitioner. 3. A review of R4’s medical record revealed a service plan dated August 04, 2025, for personal care services, including medication administration services. However, this service plan did not include a signature and date by the manager, or a nurse or medical practitioner. 4. In an interview, E3 acknowledged that R1's, R3's, and R4's service plans were not signed and dated by the required individuals. This is an uncorrected deficiency from the inspection conducted on June 9, 2025.

Based on record review and interview, the manager failed to ensure a written service plan was signed by the resident or the resident's representative. The deficient practice posed a risk if the service plan was not developed to articulate decisions and agreements. Findings include: 1. A review of R3's medical record revealed that the initial service plan dated December 2024, was not signed by the resident nor the resident's representative. 2. A review of R4's service plan revealed that the initial service plan dated May 2025, was not signed by the resident nor the resident's representative. 3. In an interview, E2 acknowledged that the facility failed to ensure R3's and R4's service plans were signed by the resident or the resident's representative.

Based on record review, documentation review, and interview, the manager failed to ensure that an employee and/or resident provided documentation of freedom from infectious Tuberculosis (TB) as specified in R9-10-113, for one of four sampled residents. The deficient practice posed a potential TB exposure risk to residents. Findings include: 1. A record review of R3’s, medical records revealed that the resident was admitted into the facility in December, 2024. 2. A record review of R3’s medical record revealed that the resident was administered a TB test prior to admission, however, the results of the test were not read. 3. A review of the facility's Policies and Procedures revealed a policy titled, "Admissions: Resident Acceptance/Residency Agreement Procedures: #4" which stated, "within 7 days of acceptance, each resident shall provide evidence of being free from pulmonary Tuberculosis. A report of a negative Mantoux Tuberculin (TB) skin test recorded along with the resident's name, date of injection, date read, the serum lot number, expiration date and follow up date (if applicable)." 4. In an interview, E2 acknowledged that the TB requirements were not met for R3.