Arizona Elderly Care Alh

Based on documentation review, observation, and interview, the manager failed to ensure for a facility authorized to provide directed care services, the means of exiting the facility for a resident who did not have a key, special knowledge for egress, or the ability to expend increased physical effort, controlled or alerted employees of the egress of a resident from the facility to the outside area allowing the resident to be at least 30 feet away from the facility. Findings include: 1. A review of Department documentation revealed the facility was authorized to provide directed care services. 2. During a facility tour with E1, the compliance officer observed that when exiting from the patio door to the backyard and two other side doors leading to the backyard, they did not control or alert employees of the egress of a resident from the facility. 3. In an interview, E1 acknowledged that the patio doors did not control or alert employees of the egress of a resident from the facility.

Based on record review and interview, the manager failed to ensure that medication administration services provided to a resident were documented in the resident's medical record for one of two sampled residents. Findings include: 1. A review of R2's medical record revealed that R2 received medication administration services. R2's record contained a medication order dated April 11, 2024, for Metoprolol 525mg one tablet at 9 pm. A review of R2's July 2025 medication administration record (MAR) revealed R2 was administered Metoprolol 525mg at 8 am from July 1, 2025, to July 2, 2025. R2's medication organizer contained Metoprolol. 2. R2's record contained a medication order dated May 24, 2024, for Losartan 100/12.5 mg one tablet every morning. A review of R2's July 2025 MAR revealed R2 was administered Losartan at 8 am and 8 pm from July 1, 2025, through July 20, 2025. 3. In an interview, E1 reviewed and acknowledged that there was no additional documentation to review, and acknowledged that R2's medication was documented not in compliance with R2's medication orders. This is a repeat deficiency from the compliance inspection and complaint investigation conducted on June 24, 2024.

Based on record review and interview, the manager failed to ensure a written service plan was updated at least once every six months, for one of two residents sampled who received personal care services. The deficient practice posed a health and safety risk to the resident if the employees did not know what services the resident needed. Findings include: 1. A review of R2's medical record revealed a service plan dated November 2, 2023. The service plan indicated R2 required personal care services. However, the review revealed no service plan(s) reviewed and updated at least once every six months after November 2, 2023. 2. In an interview, E1 confirmed R2's service plan was not reviewed and updated at least once every six months.

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 as medication could not be verified as administered against a medication order. Findings include: 1. A review of R2's medical record revealed a service plan indicating R2 required medication administration services. R2's medical record also contained a signed medication order dated November 16, 2023 for "Alendronate 70 MG (milligrams) 1 tablet by mouth once a week." Further review of R2's medical record revealed a medication administration record (MAR). The MAR indicated "Alendronate" was not administered for the entire month of May 2024 and June 2024. 2. In an interview, E1 reported R2's medication was administered but was not documented in R2's MAR.

Based on documentation review and interview, the healthcare institution failed to established, documented, and implemented tuberculosis (TB) infection control activities to include annually assessing the health care institution's risk of exposure to infectious tuberculosis. The deficient practice posed a potential TB exposure risk to residents and staff. Findings include: 1. A review of facility documentation revealed an annual assessment of the health care institution's risk of exposure to infectious TB was not available for review. 2. In an interview, E1 stated E1 was not aware of any TB risk assessment done annually, and acknowledged a TB risk assessment was not conducted this year or the prior year.