Atria Campana Del Rio

Based on record review, documentation review, and interview, the manager failed to ensure a service plan for a resident receiving personal care services included skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; offering sufficient fluids to maintain hydration; and incontinence care that ensures that a resident maintained the highest practicable level of independence when toileting, for three of three residents sampled receiving personal care services. Findings include: 1. A review of R5's medical records revealed documentation of their current written service plan dated December 18, 2023, for personal care services. The service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; and - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting. 2. A review of R6's medical records revealed documentation of their current written service plan dated November 22, 2023, for personal care services. The service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; and - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting. 3. A review of R7's medical records revealed documentation of their current written service plan dated December 14, 2023, for personal care services. The service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; and - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting. 4. In an interview, E1 and E10 acknowledged the service plans for R5, R6, and R7 did not include all the requirements in R9-10-814.F.1-4.

Based on record review, documentation review, and interview, the manager failed to ensure, before providing assisted living services to a resident, a manager or caregiver provided current documentation of first aid training for two of four caregivers sampled. The deficient practice posed a risk if the employees were unable to meet a resident's needs during an emergency. Findings include: 1. A review of E4's personnel record revealed E4 was hired as a caregiver in August 2023. 2. A review of E4's personnel record revealed documentation of an "American Safety & Health Institute CPR, AED, and Basic First Aid" card,. However, the card had a completion date of August 18, 2021, and an expiration date of August 20, 2023. No other documentation was provided to show E4 had current documentation of first aid training and cardiopulmonary resuscitation training certification specific to adults. 3. In an interview, E1, and E10 acknowledged E4 did not have current documentation of first aid training and cardiopulmonary resuscitation training certification specific to adults.

Based on record review, documentation review, observation, and interview, the manager failed to ensure a resident's medical record contained documentation of notification of the resident of the availability of vaccination for pneumonia, according to A.R.S. \'a7 36-406(1)(d) for five of seven residents sampled. This deficient practice posed a potential illness risk to residents. Findings include: A.R.S. \'a7 36-406(1)(d) states, " 1. The department shall... (d) Require as a condition of licensure that nursing care institutions and assisted living facilities make vaccinations for influenza and pneumonia available to residents on site on a yearly basis. The department shall prescribe the manner by which the institutions and facilities shall document compliance with this subdivision, including documenting residents who refuse to be immunized." 1. A review of R1's medical record revealed R1 has been residing in the assisted living facility for over eleven months. However, there was no documentation of evidence to indicate the facility offered the influenza and pneumonia vaccination on a yearly basis or documentation of R1's refusal of the pneumonia vaccination on a yearly basis. 2. A review of R2's medical record revealed R2 has been residing in the assisted living facility for more over four months. The Compliance Officer observed documentation on the influenza vaccination. However, there was no documentation of evidence to indicate the facility offered the pneumonia vaccination on a yearly basis or documentation of R2's refusal of the pneumonia vaccination on a yearly basis. 3. A review of R3's medical record revealed R3 has been residing in the assisted living facility for over 10 months. The Compliance Officer observed documentation on the influenza vaccination, However, there was no documentation of evidence to indicate the facility offered the pneumonia vaccination on a yearly basis or documentation of R3's refusal of the pneumonia vaccination on a yearly basis. 4. A review of R5's medical record revealed R5 has been residing in the assisted living facility for over four months. However, there was no documentation of evidence to indicate the facility offered the influenza and pneumonia vaccination on a yearly basis or documentation of R5's refusal of the pneumonia vaccination on a yearly basis. 5. A review of R7's medical record revealed R7 has been residing in the assisted living facility for over six months. However, there was no documentation of evidence to indicate the facility offered influenza and the pneumonia vaccination on a yearly basis or documentation of R7's refusal of the pneumonia vaccination on a yearly basis. 6. In an interview, E1 and E10 acknowledged vaccinations for influenza and pneumonia were not available to all residents on site on a yearly basis.

Based on record review and interview, the manager failed to ensure the service plan for a resident receiving directed care services included the requirements in R9-10-815(C)(1-5), for four of four sampled residents receiving directed care services. Findings include: 1. A review of R1's medical record revealed documentation of a service plan dated December 20, 2023, indicating R1 was receiving directed care services. However, the service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting; - Cognitive stimulation and activities to maximize functioning; and - Documentation of the resident's weight, or from a medical practitioner stating that weighing the resident is contraindicated. 2. A review of R2's medical record revealed documentation of a service plan dated December 20, 2023, indicating R2 was receiving directed care services. However, the service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting; - Cognitive stimulation and activities to maximize functioning; and - Documentation of the resident's weight, or from a medical practitioner stating that weighing the resident is contraindicated. 3. A review of R3's medical record revealed documentation of a service plan dated December 19, 2023, indicating R3 was receiving directed care services. However, the service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting; - Cognitive stimulation and activities to maximize functioning; and - Documentation of the resident's weight, or from a medical practitioner stating that weighing the resident is contraindicated. 4. A review of R4's medical record revealed documentation of a service plan dated November 3, 2023, indicating R4 was receiving directed care services. However, the service plan did not contain the following: - Skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections; - Incontinence care that ensures that a resident maintains the highest practicable level of independence when toileting; - Cognitive stimulation and activities to maximize functioning; and - Documentation of the resident's weight, or from a medical practitioner stating that weighing the resident is contraindicated. 5. In an interview, E1, and E10 acknowledged the service plans for R1, R2, R3, and R4 did not contain all the requirements in R9-10-815(C)(1-5).