Circle of Life Alzheimer Homes, LLC

Based on observation and interview, the manager failed to ensure that the location at which a copy of the most recent Department inspection report and any plan of correction resulting from the Department inspection could be found, was conspicuously posted. Findings include: 1. R9-101.54 states, "Conspicuously posted" means placed: a. At a location that is visible and accessible; and b. Unless otherwise specified in the rules, within the area where the public enters the premises of a health care institution." 2. During the environmental tour, the Compliance Officers observed no posting indicating where the most recent inspection report could be located. 3. In a telephonic interview, E1 acknowledged that documentation of the location at which a copy of the most recent Department inspection report and any plan of correction resulting from the Department inspection may be viewed was not posted.

Based on observation, record review, and interview, the manager failed to ensure a resident's written service plan included the amount, type, and frequency of assisted living services being provided to the resident, for one of three residents sampled. The deficient practice posed a risk as the service plans did not reinforce and clarify the services to be provided to a resident. Findings include: 1. During the environmental inspection with E2, the Compliance Officer observed that R1 had a half rail and a wedge pillow for repositioning. R1 was unable to reposition themselves and appeared frail. 2. In an interview, E2 reported that R1 was non-ambulatory and either bedbound or wheelchair-bound. R1 was unable to self-propel or take steps. E2 also reported that they repositioned R1 every 2–4 hours while providing incontinence care. 3. A review of R1's medical record revealed a document titled "Bed or Wheelchair Bound Initial Authorization/Review" dated November 23, 2021, indicating that R1 was “Bedbound/Wheelchair Bound.” R1's service plan did not include repositioning during incontinence care. 4. In a telephonic interview, E1 reported the staff repositioned R1 every 4 hours and as needed. E1 acknowledged R1's written service plans did not include the amount, type, and frequency of the services being provided to R1.

Based on observation, record review and interview, the manager failed to ensure the facility did not accept or retain a resident who was confined to a bed or chair because of an inability to ambulate even with assistance, unless the facility obtained a written determination from a medical practitioner, every six months, that stated the resident's needs could be met by the facility and the resident's needs were within the facility's scope of services, for one of one resident reviewed who was confined to a bed or chair. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. During the environmental inspection with E2, the Compliance Officer observed that R1 had a half rail and a wedge pillow for repositioning. R1 was unable to reposition themselves and appeared frail. 2. In an interview, E2 reported that R1 was non-ambulatory and either bedbound or wheelchair-bound. R1 was unable to self-propel or take steps. E2 also reported that they repositioned R1 every 2–4 hours while providing incontinence care. 3. A review of R1's medical record revealed a service plan dated July 2025 for directed care services. In addition, a review of R1's medical record revealed a document titled "Bed or Wheelchair Bound Initial Authorization/Review" dated November 23, 2021, indicating that R1 was “Bedbound/Wheelchair Bound.” 4. A review of R1's medical record revealed no documentation of a written determination from a medical practitioner, every six months, that stated the resident's needs could be met by the facility and the resident's needs were within the facility's scope of services, for R1, who was confined to a bed or chair. 5. In a telephonic interview, E1 acknowledged that R1's medical record had no documentation indicating that a medical practitioner had provided a written determination at least once every six months.