Amore Garden Assisted Living

Based on record review and interview, before or within five working days after a resident's acceptance by an assisted living facility, the manager failed to obtain on the residency agreement, the signature of the resident, the resident's representative, the resident's legal guardian, or another individual who has been designated by the individual under A.R.S \'a7 36-3221 to make health care decisions on the individual's behalf for one of two residents sampled. The deficient practice posed a risk if the resident was not informed of the terms of residency. Findings include: 1. A review of R2's medical record revealed a residency agreement. However, the residency agreement was not signed and dated by R2 or R2's representative before R2's acceptance or within five working days after acceptance. 2. In an interview, E1 acknowledged R2's residency agreement was not signed and dated by the resident or the resident's power of attorney before or within five working days after R2's acceptance.

Based on documentation review, observation, and interview, the manager failed to ensure for a facility authorized to provide directed care services, there was a means of exiting the facility for a resident who does not have a key, special knowledge for egress, or the ability to expend increased physical effort and provided access to an outside area which allowed the resident to be at least 30 feet away from the facility and controlled or alerted employees of the egress of a resident from the facility. The deficient practice posed a risk to the health and safety of residents if employees were unaware of a resident's egress from the facility. Findings include: 1. A review of Department documentation revealed the facility was authorized to provide directed care services. 2. During a tour of the facility, the Compliance Officer observed when exiting from the patio door to the backyard, no alarm sounded to alert employees of the egress of a resident from the facility. The Compliance Officer observed an alert system was installed on the patio door. However, the alert system was not functioning. 3. In an interview, E1 acknowledged the patio door did not alert employees of the egress of a resident from the facility. E1 reported the alert system upsets R3 and R3 frequently turns off the alert.

Based on record review, observation, and interview, the manager failed to ensure a medication administered to a resident was documented in the resident's medical record for one of two residents sampled. The deficient practice posed a risk if the resident experienced a change in condition due to improper administration of medication. Findings include: 1. A review of R1's medical record revealed a service plan dated February 28, 2023. The service plan revealed R1 received medication administration. 2. A review of R1's medical record revealed a medication list signed by a medical practitioner, dated July 14, 2023. The medication list included Seroquel 50 milligrams (mg), one tablet twice a day. 3. A review of R1's July 2023 medication administration record (MAR) indicated R1 received Seroquel 50 mg 1 tablet twice a day at 8:00 AM and 8:00 PM. 4. A review of R1's mediset revealed Seroquel 50 mg in the 8:00 AM slot. However, there was no Seroquel 50 mg in the PM slot. The Compliance Officer observed the aforementioned medication in the 12:00 PM slot. 5. In an interview, E1 and E2 acknowledged R1 was administered one tablet of Seroquel at 8:00 AM and 12:00 PM. However, the medication was not accurately documented on the resident's July 2023 MAR.