Arizona Royal Ranch

Based on record review and interview, the manager failed to ensure a resident provided documentation of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for one of three residents sampled. The deficient practice posed a TB exposure risk to residents. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. A review of R1's medical record revealed documentation of a TB signs and symptoms screening dated June 25, 2024. However, this signs and symptoms screening was not signed by a medical practitioner, occupation health provider, or local health agency. Based on R1's date of acceptance, this documentation was required. 3. In an interview, E1 acknowledged completing the TB signs and symptoms screening; and evidence of freedom from TB as specified in R9-10-113 was not available.

Based on observation and interview, 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 the environmental inspection of the facility, the Compliance Officers observed R4's bed with half bed rails up on both sides of the bed. 2. In an interview, E1 and E4 reported the bed rails were up to prevent R4 from falling out of bed. E1 confirmed that R4 was non-verbal and immobile which would prohibit R4 from being able to request assistance if needed. 3. E1 and E4 acknowledged the situation may cause the resident to suffer physical injury.