Generations Senior Living, L L C

Based on record review and interview for one of one sample directed care resident records, the manager failed to obtain a signed and dated statement from a medical practitioner, at least once every six months throughout the duration of the resident's condition, indicating that the resident's needs were being met by the facility as per their scope of services. Findings include: 1. During an interview, E2 indicated that R1 was non-ambulatory, has not walked for more than 30 days and cannot walk even when assisted. 2. The last determination of residency signed by a medical practitioner indicating that the resident's needs were being met as per the facility's scope of services, was dated May 18, 2017. Based on the resident's date of acceptance this documentation was required. 3. During an interview, E2 acknowledged that documentation from the medical practitioner was not in the record at least once every six months throughout the duration of the resident's condition.

Based on documentation review and interview, the manager failed to ensure that the health care institution established, documented, and implemented tuberculosis infection control activities that include policies and procedures for subsections a. through f. of this rule. Findings include: 1. Review of facility policies and procedures failed to reveal documentation indicating that the health care institution had established and documented tuberculosis infection control policies and procedures that include subsections a. through f. of this rule. 2. During an interview, E2 acknowledged that the required documentation was not available for review.

Based on record review and interview the health care institution failed to develop a training program for all staff regarding fall prevention and fall recovery as required in A.R.S. \'a7 36-420.01. The training program shall include initial training and continued competency training as identified in facility training program documentation. Findings include: 1. Review of facility documentation failed to reveal that the health care institution had developed a fall prevention and recovery training program that identified the frequency that continued competency training would occur. 2. During an interview, E2 acknowledged the required documentation was not available for review.

Based on documentation review and interview, the manager failed to ensure that a plan is established, documented, and implemented for an ongoing quality management program that, includes a method to make changes or take actions as a result of the identification of a concern about the delivery of services related to resident care. Findings include: 1. Review of the monthly facility quality management reports revealed that the reports did not include a method to make changes or take action as a result of the identification of a concern about the delivery of services related to resident care. 2. During an interview, E2 acknowledged the required documentation was not included in the facility quality management documentation.

Based on documentation review and interview, the manager failed to ensure that the health care institution established, documented, and implemented tuberculosis infection control activities that included annually assessing the health care institution's risk of exposure to infectious tuberculosis. Findings include: 1. Review of facility documentation failed to reveal an annual assessment of the health care institution's risk of exposure to infectious tuberculosis. 2. During an interview, E2 acknowledged that the required documentation was not available for review.