Grace Assisted Living Home

Based on documentation review, record review, and interview, the manager failed to ensure a residency agreement contained provisions allowing a manager to terminate residency of a resident in compliance with A.A.C. R9-10-807(G), for two of two residents sampled. The deficient practice posed a risk if the resident was not informed of the terms of residency. Findings include: 1. A review of facility documentation revealed a policy and procedure titled "Termination of Residency" (dated in February 2022). The policy and procedure stated "1. A Manager may terminate residency of a resident as follows:... ii. The individual requires continuous medical services, nursing services (unless the facility complies with behavioral health services) iii. The assisted living services needed by the individual are not within the facility's scope of services; iv. The facility does not have the ability to provide the assisted living services needed by the individual' or v. The individual requires restraints, including the use of bedrails." 2. A review of R1's medical record revealed a residency agreement. The residency agreement stated "A. A Manager shall not accept or retain an individual if: a. The individual requires continuous: a. Medical services; b Nursing services; c. Behavioral health services; b. The assisted living services needed by the individual are not within the assisted living facility's scope of services; c. The assisted living facility does not have the ability to provide the assisted living services needed by the individual; or d. The individual requires restraints, including the use of bedrails." However, documentation to indicate the residency agreement contained provisions allowing a manager to terminate residency of a resident in compliance with A.A.C. R9-10-807(G) was not available for review. 3. A review of R2's medical record revealed a residency agreement. The residency agreement stated "A. A Manager shall not accept or retain an individual if: a. The individual requires continuous: a. Medical services; b Nursing services; c. Behavioral health services; b. The assisted living services needed by the individual are not within the assisted living facility's scope of services and a home health agency or hospice service agency is not involved in the care of the individual; c. The assisted living facility does not have the ability to provide the assisted living services needed by the individual; or d. The individual requires restraints, including the use of bedrails." However, documentation to indicate the residency agreement contained provisions allowing a manager to terminate residency of a resident in compliance with A.A.C. R9-10-807(G) was not available for review. 4. In an interview, E1 acknowledged R1's residency agreement did not include the correct provisions for an assisted living facility to terminate residency with a fourteen-day written notice which was required to include the primary condition for which the individual needs assisted l