Asante Adult Care Home

Based on observation and interview, the manager failed to ensure that 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 that controls or alerts employees of the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident. Findings include: 1. During the environmental inspection of the facility, the Compliance Officers observed a door labeled “Employees Only” which led to the garage that was unlocked and had no alarm. The door had a key lock; however, it was not locked at the time of the survey. 2. In an interview, E2 and E3 acknowledged that there was a means of exiting the facility to the garage, which did not control or alert employees of the egress of a resident from the facility.

Based on observation and interview, the manager failed to ensure that medication was stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage. The deficient practice posed a risk to residents who were unable to self-administer medications. Findings include: 1. During the facility tour, the compliance officers observed that cabinets containing residents' medications were equipped with magnetic locks. However, the key for the magnetic locks was kept on the side of the refrigerator, next to the cabinet. The Compliance Officers were able to access the key and open the medication cabinet. 2. In an interview, E2 acknowledged that the manager failed to ensure that medication was stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage. E2 reported that they will move the release device out of sight from others.

Based on observation, documentation review, and interview, the manager failed to ensure that poisonous or toxic materials stored by the assisted living facility were maintained in labeled containers in a locked area separate from food preparation and storage, dining areas, and medications, and were inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During an environmental inspection of the facility with E2 and E3, the Compliance Officers observed a door labeled “Laundry Room” that was locked with the key hanging on the door frame. The room was accessible to residents and the room contained the following toxic chemicals: Laundry detergent; Liquid bleach; Multi-purpose cleaner; and Disinfectant spray. 2. A review of the facility’s Policies and Procedures revealed a policy titled “Emergency, Safety and Environmental Standards” which stated, “Access to Laundry Services: Residents DO NOT HAVE access to the laundry room. The facility staff provides laundry service to residents”. 3. In an interview, E2 acknowledged the aforementioned poisonous or toxic materials were not maintained in a locked area and inaccessible to residents.

Based on record review and interview, the manager failed to ensure a written service plan included the amount, type, and frequency of assisted living services provided for one of two residents reviewed. The deficient practice posed a risk if a resident's service plan did not include the services to be provided. Findings include: 1. Review of R2's medical record revealed a written service plan dated April 12, 2023. This service plan indicated R2 was incontinent of bladder and bowel and was dependent on the caregiver for assistance, however did not indicate the amount, type, and frequency of the incontinence care. 2. In an interview, E1 reported R2 was incontinent of bladder and bowel and was dependent on the caregiver for assistance and acknowledged R2's service plan did not include the amount, type, and frequency of assisted living services provided to R2.

Based on record review, observation, and interview, the manager failed to ensure a resident's medical record included the correct strength and dosage, for a medication administered to one of two residents reviewed. The deficient practice posed a risk as medication administration could not be verified against a medication order. Findings include: 1. Review of R2's medical record revealed a current written service plan dated April 12, 2023. This service plan indicated R2 received medication administration. 2. Review of R2's medical record revealed signed medication orders dated May 24, 2023. These medication orders stated the following: "Clonidine 0.1mg 1 tab po 4x a day" "Metformin 500mg 1 tablet po BID" 3. Review of R2's medical record revealed an August 2023 medication administration record (MAR). This MAR stated the following: "Clonidine HCL PO QID" and indicated one tab was administered at 6am, 12pm, 6pm, and 12am August 1st - present. "Metformin HCL Tablet 500mg 2 tabs PO BID" and indicated two tabs were administered at 8am and 8pm August 1st - present. 4. During an observation of R2's medications, the following was observed: Clonidine 0.1mg was observed and one tab was observed prefilled in the "6am," "12pm," "6pm," and "12am" slot of R2's medication organizer. Metformin 500mg was observed and one tab was observed prefilled in the "8am" and "8pm" slot of R2's medication organizer. 5. In an interview, E1 reported the medications were administered per the medication order and acknowledged R2's MAR did not include the correct strength and dosage of the administered medications.

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 reviewed. The deficient practice posed a risk as medication could not be verified as administered against a medication order. Findings include: 1. Review of R1's medical record revealed a current written service plan dated July 31, 2023. This service plan indicated R1 received medication administration. 2. Review of R1's medical record revealed a signed medication order dated July 28, 2023. This medication order stated "Mucinex ER 600mg tablet - Take one tab PO BID for 7 days". 3. Review of R1's medical record revealed an August 2023 medication administration record (MAR). This MAR did not include documentation Mucinex ER 600mg was administered August 1st - present. 4. During an observation of R1's medications, Mucinex ER 600mg was observed and one tab was observed prefilled in the "Morn" and "Night" slot of R1's medication organizer. 5. In an interview, E1 reported the medication was administered per the medication order and acknowledged R1's medical record did not include documentation the medication was administered.

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 E1, the Compliance Officer observed a rechargeable fire extinguisher. This fire extinguisher had a receipt attached showing a purchase date of July 6, 2022. 2. In an interview, E1 acknowledged the rechargeable fire extinguisher was not serviced at least once every 12 months.

Based on observation and interview, the manager failed to ensure oxygen containers were secured in an upright position. The deficient practice posed a potential explosion or leak of a compressed gas. Findings include: 1. During an environmental inspection of the facility with E1, the Compliance Officer observed three large oxygen tanks unsecured in the facility garage. 2. In an interview, E1 acknowledged oxygen tanks were not secured in an upright position.

Based on observation, documentation review, and interview, the administrator failed to ensure a resident bedroom was not used as a passageway to another sleeping area. The deficient practice posed a potential privacy rights violation to the resident. Findings include: 1. During an environmental inspection of the facility with E1, the Compliance Officer observed R1's bedroom, bathroom, and closet. The Compliance Officer observed a bed in the closet. 2. In an interview, R1 reported E1 slept in the closet. 3. Review of Department records revealed the facility was originally licensed in 2022, therefore an exception from the Department before October 1, 2013 would not apply. 4. In an interview, E1 reported E1 occasionally slept in R1's closet and acknowledged a resident bedroom was used as a passageway.