Blessed Assisted Living Home LLC - Gilbert

Based on record review and interview, the assisted living home failed to maintain a standardized form for each resident that included the information prescribed in A.R.S. § 36-420.04.A.1-9 for two out of two residents sampled. The deficient practice posed a risk if the facility was not prepared in case of an emergency. Findings include: 1. A review of R1's medical record revealed there was a standardized form to be used if an emergency responder was contacted, however, the form did not include the following information: The name, address and telephone number of the resident's current pharmacy; Basic information about the resident's physical and mental conditions and basic medical history; The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address; and A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge. 2. A review of R2's medical record revealed there was a standardized form to be used if an emergency responder was contacted, however, the form did not include the following information: The name, address and telephone number of the resident's current pharmacy; Basic information about the resident's physical and mental conditions and basic medical history; The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address; primary care doctor's name; A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge; and A list of any known allergies to any medications, additives, preservatives or materials. 3. In an exit interview, the findings were reviewed with E1 and no additional information was provided.

Based on record review, documentation review, and interview, the health care institution failed to ensure that the health care institution established, documented, and implemented tuberculosis (TB) infection control activities that included annually providing training and education related to recognizing the signs and symptoms of TB and annually assessing the health care institution's risk of exposure to infectious TB. The deficient practice posed a TB exposure risk to residents. Findings include: 1. A review of E1's personnel record revealed documentation of training and education for recognizing the signs and symptoms of infectious TB completed on May 30, 2024. No current documentation was available. 2. A review of E2's personnel record revealed documentation of training and education for recognizing the signs and symptoms of infectious TB completed on May 30, 2024. No current documentation was available. 3. A review of the facility's documentation revealed no documentation of annually assessing the health care institution's risk of exposure to infectious tuberculosis. 4. In an exit interview, the findings were reviewed with E1 no additional information was provided.

Based on documentation review, record review, and interview, the manager failed to ensure compliance with A.R.S. § 36-411, for two of two employees sampled. The deficient practice posed a risk if the employee was a danger to a vulnerable population. Findings include: 1. A review of A.R.S. § 36-411 states "Each residential care institution, nursing care institution and home health agency shall make documented, good faith efforts to: 3. Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459. If a potential employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency may not hire the potential employee. 4. On or before March 31, 2025, verify that each employee is not on the adult protective services registry pursuant to section 46-459. If an employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency shall take action to terminate the employment of that employee. 5. Beginning March 31, 2025, annually reverify that each employee is not on the adult protective services registry pursuant to section 46-459." 2. A review of E1 and E2's personnel records revealed no documentation that E1 and E2 were not on the adult protective services registry. 3. In an exit interview, the findings were reviewed with E1 and no additional information was provided.

Based on documentation and interview, the manager failed to ensure that a disaster plan included how a resident’s medical record will be available to individuals providing services to the resident during a disaster, a plan to ensure each resident’s medication will be available to administer to the resident during a disaster, and a plan for obtaining food and water for individuals present in the assisted living facility or the assisted living facility’s relocation site during a disaster. The deficient practice posed a risk as there was no plan to ensure the health and safety of residents in an emergency. Findings include: 1. A review of the facility’s documentation/policies and procedures revealed a disaster plan for the facility, however, the plan did not include: how a resident’s medical record will be available to individuals providing services to the resident during a disaster; a plan to ensure each resident’s medication will be available to administer to the resident during a disaster; and a plan for obtaining food and water for individuals present in the assisted living facility or the assisted living facility’s relocation site during a disaster; 2. In an exit interview, the findings were reviewed with E1 and no additional information was provided.