Harvard House of Care 2 LLC

Based on record review and interview, the manager failed to ensure a resident accepted by the assisted living facility submitted documentation signed by a medical practitioner or a registered nurse that stated whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints, for one of two residents reviewed. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. A review of R1's medical record revealed no documentation was available for review verifying if R1 required continuous medical services, continuous or intermittent nursing services, or restraints; dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant. 2. In an interview, E1 acknowledged R1 did not submit documentation signed by a medical practitioner or a registered nurse that stated whether the R1 required continuous medical services, continuous or intermittent nursing services, or restraints dated within 90 days before R1 was accepted by the facility.

Based on observation and interview, the manager did not ensure poisonous or toxic materials stored by the assisted living facility was inaccessible to residents. Findings include: 1 . During an environmental inspection, the Compliance Officer observed the following items on a shelf in a bathroom accessible by residents: "Dream Bright - Bath and Body Works - Fine Fragrance Spray"; "Febreze Air Mist - Hawaiian Aloha"; and "Great Scents Air Freshener - 5 in 1". 2 . During an interview, E4 acknowledged poisonous or toxic materials stored by the assisted living facility was accessible to residents.

Based on record review, and interview, the manager failed to ensure a resident medical record contained documentation of notification of the resident of the availability of vaccination for influenza (flu) and pneumonia, according to A.R.S. \'a7 36-406(1)(d), to one of two residents reviewed. Findings include: 1. Review of R1's medical record revealed R1 refused the flu and pneumonia vaccinations July 20, 2022. However, current documentation was not available showing the flu and pneumonia vaccinations were offered or received. Based on R1's acceptance date, this documentation was required. 3. In an interview, E1 reported flu and pneumonia was offered to R1 who refused in July 2023 however, E1 did not document the refusal. E1 acknowledged R1's medical record did not include current documentation showing the flu and pneumonia vaccinations were offered or received.

Based on observation and interview, the manager failed to ensure oxygen containers were secured in an upright position. Findings include: 1. During a facility tour with E1, the compliance officer observed two oxygen cylinders sitting upright, but unsecured, next to an empty oxygen tank stand located in the hallway of the facility. The compliance officer observed two additional oxygen cylinders sitting upright, but unsecured, in another area of the hallway. 2. During an interview, E 1 reported two of the four tanks were empty and awaiting pick up. E1 acknowledged the manager failed to ensure oxygen containers were secured in an upright position.