Bee Hive Homes

Based on record review and interview, the manager failed to ensure a caregiver documented the services provided in the resident's medical record, for four of eight residents sampled. Findings include: 1. A review of R1’s and R2’s medical records revealed each resident had a service plan describing the services to be provided to each resident. Further review revealed documents titled “Resident Monthly ADL,” used for documenting services and activities of daily living (ADL). The ADL tracking sheets for each resident contained multiple gaps, for each resident, where required services had not been documented as having been provided. 2. In an interview, E1 acknowledged the services provided to each resident had not been accurately documented on the provided ADL forms.

Based on observation, record review, and interview, the governing authority failed to ensure compliance with A.R.S. \'a7 36-411, which required employees to have a valid fingerprint clearance card; for one of seven sampled personnel records reviewed, which posted a safety risk. Findings include: 1. Review of the sampled personnel records revealed E2 was hired on December 10, 2021 as a caregiver. E2's record contained a copy of a fingerprint clearance card that was issued February 27, 2018 and expired on February 27, 2024. There was no documentation that E2 had a current fingerprint clearance card. E2 was observed working on the day of the compliance inspection. 2. In an interview, E1 acknowledged there was no documentation that E2 had a current fingerprint clearance card. 3. The compliance officer verified on the DPS website that E2 did not have a current fingerprint clearance card nor an application for a fingerprint clearance card.

Based on record review and interview, the manager failed to ensure a written service plan was completed no later than 14 calendar days after the resident's date of acceptance for two of two sampled residents records reviewed, which posed a health and safety risk to the resident if the caregivers did not know what services the resident needed. Findings include: 1. Review of R1's and R2's records revealed a written service plan; however, based on R1's and R2's acceptance dates, these were completed more than 14 calendar days after R1 and R2 had been accepted to the facility. The service plans stated R1 and R2 required personal care and medication administration services. 2. During an interview, E1 acknowledged R1's and R2's service plans had not been completed within 14 calendar days after each of the residents had been accepted.

Based on documentation review and interview, the manager failed to ensure the disaster plan required in subsection (A)(1) was reviewed at least once every 12 months which posed a safety risk. Findings include: 1. During the review of the facility's documents that were requested earlier at the beginning of the compliance inspection revealed there was no documentation as evidence the facility had reviewed the disaster plan and documented as required during the past 12 months. 2. In an interview, E1 acknowledged there was no documented evidence the disaster plan was reviewed and documented as required in the past 12 months.

Based on record review and interview, the manager failed to ensure, for a resident receiving services from a hospice agency, the resident's medical record contained a copy of the follow-up instructions provided to the resident by the hospice agency, for one of one sampled resident receiving hospice services which could pose a health risk to the resident if the caregivers did not know how to care for the needs of the resident. Findings include: 1. In an interview, E1 reported that R4 was receiving weekly hospice services. 2. A review of R4's medical record revealed there was no documentation from the hospice agency that was providing services to the resident. The documentation should have included a copy of follow-up instructions provided to the resident by the hospice agency. 3. In an interview, E1 acknowledge there was no documentation from the hospice agency of the weekly services provided or follow-up instructions. Technical assistance was provided during the compliance inspection on March 22, 2023.

Based on record review and interview, the manager failed to ensure a caregiver or an assistant caregiver is only assigned to provide the assisted living services the caregiver or assistant caregiver has the documented skills and knowledge to perform; for five of five sampled caregivers which posed a health and safety risk. Findings include: 1. Reviewed the personnel records for E2 started December 10, 2021, E3's start date October 6, 2021. E5's start date September 29, 2023, E6's start date January 1, 2024, and E7's started September 4, 2023. These sampled caregivers' records contained no verified documentation that they had skills and knowledge to care for R2's indwelling catheter. 2. In an interview, E1 acknowledged there was no verified documentation available for review of the caregivers' skills and knowledge for catheter care. E2 reported the caregivers daily observe the catheter, empty the catheter bag, and provided peri care as needed.