Coronado Ranch Ach

Based on documentation review, record review, and interview, the manager of the assisted living home failed to maintain a standardized form for each resident that included the information prescribed in Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1-9). The deficient practice posed a risk if the emergency responder was not aware of critical health information for a resident. Findings include: 1. A.R.S. § 36-420.04.A.1-9 states, “Emergency responders; patient information; hospitals; discharge planning; patient screenings; discharge document A. An assisted living center or assisted living home that contacts an emergency responder on behalf of a resident shall provide to the emergency responder a written document that includes all of the following: (...).” 2. A review of R1 and R2's medical records revealed documentation of the standardized EMS form; however, it did not include the following: Whether the resident receives medication services and, if the resident had provided this information to the assisted living home, a list of all the resident's prescription and over-the-counter medications, their dosages, and how frequently they were administered; A list of any known allergies to any medications, additives, preservatives, and materials like latex or adhesive; Basic information about the resident's physical and mental conditions and basic medical history, as well as dates of recent episodes, if known; 3. In an interview, E1 acknowledged that a standardized form for emergency responders for R1 and R2 was not completed. 4. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on record review and interview, the manager failed to ensure an employee provided documentation of freedom from infectious tuberculosis (TB) on or before the date the individual began providing services at or on behalf of the assisted living facility, as specified in R9-10-113, for one of three employees reviewed. The deficient practice posed a potential TB exposure risk to residents. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. Review of the Centers for Disease Control and Prevention website revealed a web page titled "TB Screening and Testing of Health Care Personnel." The web page stated, "If the Mantoux tuberculin skin test (TST) is used to test health care personnel upon hire (preplacement), two-step testing should be used." 3. Review of E3's personnel record revealed one negative TB skin test that was less than 12 months old at the time of hire, however no additional documentation of freedom from infectious TB was available for review. 4. In an interview, E4 acknowledged E3 did not provide documentation of freedom from infectious TB as specified in R9-10-113 on or before the date the individual began providing services at or on behalf of the assisted living facility. 5. Technical assistance was provided on this Rule during the compliance inspection conducted October 3, 2022.

Based on record review, interview, and documentation review, the manager failed to ensure a food menu included any food substitutions no later than the morning of the day of meal service with a food substitution. Findings include: 1. Review of R1's medical record revealed a service plan for personal care which stated "Nutrition: Diet: Diabetic". 2. In an interview, E4 reported that R1 received an alternate diet for diabetes, as well as substitutions when the prepared food gave R1 heartburn. 3. Review of facility documentation revealed a posted food menu for June 2024, which stated "substitution available", however substitutions and a therapeutic diet for R1 were not documented. 4. In an interview, E4 acknowledged the food menu did not include food substitutions no later than the morning of the day of meal service with a food substitution.

Based on observation and interview, the manager failed to ensure foods requiring refrigeration were maintained at 41\'b0 F or below. The deficient practice posed a health risk to the residents. Findings include: 1. During the facility tour, the Compliance Officer observed an open container of "Sweet Brown Sugar Barbecue Sauce" and "Kraft Cheez Whiz Cheese Dip" in a kitchen cabinet. Both of these containers stated "Refrigerate after opening." 2. During an interview, E4 acknowledged the foods were stored at room temperature and required refrigeration. 3. Technical assistance was provided on this Rule during the compliance inspection conducted on October 3, 2022.

Based on observation and interview, the manager failed to ensure that a common bathroom contained a window that opened or another means of ventilation. Findings include: 1. During a facility tour, the Compliance Officer observed the common bathroom was equipped with a ventilation fan, however, it was not functional and there was no window or another means of ventilation. 2. In an interview, E4 stated "[the fan] does not seem to be working." E4 acknowledged there was no window or any other means of ventilation in the common bathroom.