Bloomfield House

Based on documentation review, record review, and interview, the health care institution failed to administer a training program for all staff regarding fall prevention and fall recovery. The deficient practice posed a risk as organized instruction and information related to resident care and safety was not implemented. Findings include: 1. A review of facility documentation revealed the facility had a training packet for fall prevention and fall recovery training for employees. However, a review of the documentation revealed the packet did not include instruction on fall recovery. 2. In record review, the personnel records for E2, E3, and E4 did not include documentation the personnel received training on fall recovery. 3. During an interview, the findings were reviewed with E1, who reported the training packet was provided to the caregivers to read. E1 reviewed the packet and acknowledged the packet did not include training on fall recovery.

Based on record review, and interview, for two of two residents reviewed, the manager failed to ensure a resident's medical record contained documentation of notification of the residents of the availability of vaccination for influenza and pneumonia vaccination. The deficient practice posed a health and safety risk if a resident or representative did not have knowledge of the availability of the vaccination. The statute reads: A.R.S. \'a7 36-406(1)(d) 36-406. Powers and duties of the department In addition to its other powers and duties: 1. The department shall: 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. The department shall not impose a violation on a licensee for not making a vaccination available if there is a shortage of that vaccination in this state as determined by the director. Findings include: 1. In record review, the medical records for R1, R2, and R3 did not include documentation of notification of the residents of the availability of vaccination for pneumonia. Based on the resident's acceptance date, this documentation was required. 2. During an interview, the findings were reviewed with E1, who acknowledged the residents' medical records did not include documentation of notification of the residents of the availability of the pneumonia vaccination.

Based on record review and interview, the manager failed to ensure that food was prepared using methods that conserve flavor and appearance. The deficient practice posed a risk to a resident's right to be treated with dignity and respect, by having food prepared and served in a manner to conserve flavor and appearance. Findings include: 1. Based on record review, the medical records for R2 and R3 revealed the residents received a pureed diet. R3's service plan indicated R3 received a "finely chopped" diet. 2. During an interview, E2 reported, for residents who required a puree diet, the facility pureed the residents' food, by mixing all of the food, (i.e., protein, vegetables, fruit, etc.) together in the food blender. E1 and E2 acknowledged the process of mixing different foods together may not conserve the foods' flavor and appearance, for the residents.

Based on documentation review, record review, and interview, for three of four employees reviewed, the health care institution failed to implement tuberculosis (TB) infection control activities including annually providing training and education related to recognizing the signs and symptoms of TB to individuals employed by the health care institution. The deficient practice posed a risk as the caregiver received no organized instruction or information related to TB surveillance. Findings include: 1. In documentation review, a review of facility's documents revealed the facility had not established, documented and implemented TB infection control activities, to include annual training and education related to recognizing the signs and symptoms of TB. 2. In record review, the personnel records for E2 (hired on February 18, 2011), E3 (hired on October 30, 2017), and E4 (hired on January 28, 2013) did not include documentation of training and education related to recognizing the signs and symptoms of TB. 3. During an interview, E1 acknowledged the facility did not provide annual training for employees on recognizing the signs and symptoms of TB. 4. Technical assistance was provided during the compliance inspection conducted on January 24, 2023.