Brookdale Skyline-Alr

A revisit survey was completed on 11/4/25 for all previous deficiencies cited on 6/16/25. The facility is in compliance with all deficiencies that were cited. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A licensure complaint, prompted by #CO40133, #CO39714, #CO39263, and #CO38886, was completed on 6/16/25. Deficiencies were cited. Based on observations and interviews, the residence failed to provide a variety of foods in sufficient amounts to satisfy resident appetites and failed to make available appealing substitutes of similar nutritional value, affecting 95 current residents. (Cross-reference T2140)Findings include:On 6/16/25 at 12:00 p.m., observation of the lunch service revealed that the residence did not have an alternative option listed on the "Always Available" alternative options menu.Resident council meeting minutes dated 5/13/25 at 10:40 a.m. read in part: "Recurring feedback about the oranges served lately. They are hard to peel and don ' t taste good," and "Still issues with consistency regarding porti.. Based on record review and interview the residence failed to comply with all occurrence reporting requirements by state law affecting two of five sample residents (#1 and #5). (Cross-reference B0714)Findings Include:1. Record ReviewResident #1 was admitted to the residence 5/7/25 with a diagnosis of hypothyroidism, chronic kidney disease, hypertension and cognition impairment.A care plan dated 5/7/25 read that Resident #1 would receive assistance with all of their medications.An incident investigation dated 5/18/25 read that Staff #4 informed the Licensed Practical Nurse (LPN) that she gave Resident #1 a different resident' s medications. On 6/16/25 the department quality assuran.. Based on record review and interview the residence failed to prevent staff from administering another residents medication to another resident affecting two of five sample residents (#1 and #5). (Cross-reference T0430)Findings Include:1. Record ReviewResident #1 was admitted to the residence 5/7/25 with a diagnosis of hypothyroidism, chronic kidney disease, hypertension and cognition impairment.A care plan dated 5/7/25 read that Resident #1 would receive assistance with all of their medications.An incident investigation dated 5/18/25 read that Staff #4 informed the LPN that she gave Resident #1 a different resident' s medications.A progress note dated 5/18/25, read that Reside.. Based on record review and interviews, the residence failed to provide a therapeutic diet for one of the eleven sample residents (#3). (Cross-reference T2112)Findings include:The residence ' s approved diet policy, dated 5/2025, read in part: "Diets other than those listed on the approved diets policy may be offered under the direction and supervision of a local registered/licensed dietitian and in compliance with state regulations."Resident #3 was admitted on 3/4/25 with a diagnosis of celiac disease.A practitioner ' s order, dated 4/5/23, read in part: "gluten-free diet."A care plan, dated 10/11/24, read in part: "resident receives the following diet: gluten-free diet."An aftercare summary from an .. No response is necessary.The residence was advised it must review and maintain the following processes in accordance with existing program regulations found at 6 CCR 1011-1, Chapter 7.6.1 In order to ensure that the administrator or individual appointed as an interim administrator is of good, moral, and responsible character, the assisted living residence shall request a fingerprint-based criminal history record check with notification of future arrests for each prospective administrator prior to hire, or within 10 days of appointment for an interim administrator.(A) If an administrator applicant has lived in Colorado for more than three (3) years at the time of application, the assisted liv..

A revisit survey was completed on 1/28/25 for all previous deficiencies cited on 10/16/24. The facility is in compliance with all deficiencies that were cited. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A relicensure survey with complaint #CO34205 was completed on 10/16/24. Deficiencies were cited. Based on observation, record review, and interview, the residence failed to notify the department of a change in the administrator, affecting 36 current residents.Findings include:On 10/15/24 the administrator of record was not the acting administrator at the residence.On 10/16/24 at approximately 11:00 a.m., the acting administrator said she had been in the administrator position for approximately six months. She said she was unsure who was responsible for updating the administrator on record. Based on record review and interview the residence failed to detail in each resident' s care plan the individualized approaches necessary to address fall risk, affecting three of six sample residents (#1, #5, #6).Findings include:1. Resident #6 was admitted to the residence on 7/1/22 with diagnoses of Alzheimer' s disease and type two diabetes. Record review revealed the resident fell three times from 9/6/24 to 10/11/24.Specifically, fall reports read that Resident #6 had a fall after losing his balance on 9/6/24 in his living room and was experiencing neck pain following the fall. Resident #6 had another fall after losing his balance on 9/12/24, which resulted in a skin tear to his left palm. A care plan, dated 4/10/24, read in part that the resident required universal fall precautions. However, the ca.. Based on record review and interview, the residence failed to re-assess residents every six months for the need of a secure environment, affecting three of six sample residents in the secure environment (#1, #5, #6). Findings include:1. Resident #6 was admitted to the residence on 7/1/22 with a diagnosis of Alzheimer' s disease. The record for Resident #6 contained an evaluation for the secure environment, dated 6/28/22. However, the record contained no further evidence that the residence re-assessed the resident every six months for the need of a secure environment. On 10/15/24 at approximately 10:30 a.m., the administrator said he did not know the residence was required to assess residents in the secure environment every six months to determine their continued need for a secure environment.2... THIS PORTION OF THE REPORT IS FOR INFORMATIONAL PURPOSES ONLY.No response is necessary.The residence was advised it must review and maintain the following processes in accordance with existing program regulations found at 6 CCR 1011-1, Chapter 7.8.8 Each assisted living residence shall place in a visible location a list of all staff who have current certification in first aid or CPR so that the information is readily available to staff at all times. The list shall be kept up to date and indicate by staff person whether the certification is in first aid or CPR or both. 10.1 The assisted living residence shall have readily available a roster of current residents, their room assignments and emergency contact information, along with a facility diagram showing room locations. 14.31 The administrator and the QMAP su..

A revisit survey was completed on 9/19/23 for all previous deficiencies cited on 2/23/23. The facility is in compliance with all deficiencies that were cited. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A licensure revisit was completed on 2/23/23 for all previous deficiencies cited on 6/30/22. A deficiency was cited. Based on interview and record review, the residence failed to be responsible for complying with authorized practitioner' s orders associated with medication administration, affecting three of five sample residents (#6, #15, #17).This deficiency was cited previously during a state licensure survey 6/30/22. Although the residence corrected the deficiency, based on the findings below, the residence has not maintained compliance with this regulatory requirement.Findings include:1. Residence policyThe residence' s Medication Administration policy, dated 3/31/22, read in part, "Medication assistance and administration should only be in accordance with the prescriber' s orders."2. Resident #17 was admitted to the residence on 4/26/22.A written practitioner' s order, dated 1/19/23 and 2/13/23, directed the residence to administer acyclovir 200 mg three times daily. However, the February 2023 medication administration record (MAR) read the staff administered the medication twice daily from 2/1-2/21/23, for a total of 21 missed doses.On 2/22/23 at approximately 4:00 p.m., the nurse stated she was responsible for inputting medication orders into the MAR. She stated the medication used to be ordered for twice daily; however, she did not realize the order changed to three times daily on 1/19/23. Therefore, she confirmed the medication was not adminis.. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A licensure complaint, prompted by #CO30519 and #CO30899, was completed on 2/23/23. Deficiencies were cited. Based on interview and record review, the residence failed to be responsible for complying with authorized practitioner' s orders associated with medication administration, affecting three of five sample residents (#6, #15, #17).Findings include:1. Residence policyThe residence' s Medication Administration policy, dated 3/31/22, read in part, "Medication assistance and administration should only be in accordance with the prescriber' s orders."2. Resident #17 was admitted to the residence on 4/26/22.A written practitioner' s order, dated 1/19/23 and 2/13/23, directed t.. Based on interview and record review, the residence failed to either directly or indirectly provide personal services, affecting one of five sample residents (#15). (Cross-reference Q1150)Findings include:1. Resident agreementThe residence' s sample resident agreement, dated April 2021, read in part, "Prior to moving in and periodically throughout your residency, we will use a personal service assessment to determine the personal services you require."2. Resident #15 was admitted to the residence on 1/26/21 with diagnoses including vascular dementia and legal blindness.The ca.. Based on interview and record review, the residence failed to ensure care plans detailed specific personal service needs and preferences along with the staff tasks necessary to meet those needs, affecting one of five sample residents (#15). (Cross-reference Q1110)Findings include:Resident #15 was admitted to the residence on 1/26/21 with diagnoses including vascular dementia and legal blindness.The care plan for the resident, dated 1/30/22, read in part, the resident required bathing assistance once a week on Fridays by external hospice.On 2/22/23 at 8:39 a.m., Resident #.. Based on interview and record review, the residence failed to have at least one staff member onsite at all times who had current certification in cardiopulmonary resuscitation (CPR) and obstructed airway techniques from a nationally recognized organization, affecting 74 current residents (Cross-reference Q2130).Findings include:1. Residence policy and referencesa. The residence' s CPR policy, dated January 2023, read in part, "If a resident goes into cardiac and/or pulmonary arrest, it is our policy to call 911 and follow instructions of the operator."b. According to Mayo Clinic, "Car.. Based on interview and record review, the residence failed to have at least one staff member onsite at all times who had current certification in first aid from a nationally recognized organization, affecting 74 current residents.Findings include:1. Referencea. According to the National CPR Foundation (NCPRF), "NCPRF provides self-training through the materials found on the Website(s) you' re your own (teacher). Our services are designed with OSHA (Occupational Safety and Health Administration), the ECC (Emergency Cardiovascular Care)/ILCOR (The International Liaison Commi.. Based on record review and interview, the residence failed to ensure resident records included progress notes and an advance directive, affecting two of five sample residents (#16, #17) and one former resident (#18). (Cross-reference Q734)Findings include:1. Resident #16 was admitted to the residence on 1/26/21 with diagnoses including legal blindness and vascular dementia. A progress note, dated 1/26/23, read in part, the resident was sent to the emergency department due to a fall. The emergency department communicated that the resident' s pacemaker was ..