Destiny Family Care Home #4

The facility failed to ensure that 2 out of 3 sampled residents had their assessments and care plans updated annually. Specifically, records for Resident #1 and Resident #3 showed no care plan updates since 2022.

The facility failed to provide adequate supervision for a resident with a known history of wandering and incompetent status, resulting in the resident eloping from the facility on four occasions. Specifically, the facility director failed to report the initial disappearance to authorities, choosing instead to wait several days to see if the resident would return.

The facility failed to provide adequate supervision for a resident who was adjudicated incompetent and had a known history of wandering and risky behaviors. This lack of supervision resulted in the resident eloping from the facility on four separate occasions and remaining missing.

The facility failed to provide adequate supervision for a resident, which resulted in six falls between December 2023 and January 2024, including injuries such as broken ribs and a broken arm. Records indicated the resident's needs were not properly managed, and some falls were not properly reported in incident logs.

The facility failed to provide adequate supervision for a resident in accordance with their care plan, resulting in six falls between December 2023 and January 2024. These falls led to serious injuries, including broken ribs and a broken left arm. The resident's needs for assistance and monitoring were not met, as evidenced by multiple incidents where the resident fell while walking or moving without proper support.

The facility failed to ensure that 2 of 3 sampled residents admitted to the facility were tested for tuberculosis according to the required two-step TB skin test control measures. Specifically, documentation was missing for the second step of the TB skin test for both Resident #1 and Resident #2.

The facility failed to offer or make snacks available to residents three times per day as required. Interviews with residents and staff revealed that snacks were only provided when residents specifically asked for them, rather than being proactively offered.

The facility failed to develop an activity program that promoted active involvement for all residents. Observations showed a lack of activity supplies, and interviews indicated that residents primarily engaged in watching television because staff did not change activities when residents showed no interest.

The facility failed to offer or make snacks available to residents three times per day as required by the menu. Interviews with residents and staff revealed that snacks were only provided upon request rather than being proactively offered. The PCA admitted to not offering snacks, assuming residents were not hungry if they did not ask.