High Desert Assisted Living-House 1 LLC

8.7506.C.1 Member Eligibility (a) Members enrolled in the HCBS Elderly, Blind and Disabled (EBD) and the HCBS Community Mental Health Supports (CMHS) Waivers to are eligible to receive services in an Alternative Care Facility. (i) Potential Members shall be assessed, at a minimum, by a team that includes the Member and/or Guardian or other Legally Authorized Representative, the Alternative Care Facility administrator or appointed representative, and Case Management Agency Case Manager to determined that the Alternative Care Facility is an appropriate community setting that will meet the Member' s choice and need for independence and community integration. If one of the parties listed above is not available, input or information must be obtained from each party prior to making an admission determination. The team may also include Family Members, Accountable Care Collaborative or Mental Health Center Case Managers, and any other interested parties as approved by the Member. (1) An assessment shall be conducted prior to admission, annually, whenever there is a significant change in physical, cognitive, or behavioral needs, or as requested by the Member. The annual assessment must be completed by the team described in Sections 8.7506.C.1.a.i. (2) The assessment shall document that the setting will support the Member and their needs. The ass.. A certification complaint, prompted by #CO39007, was completed on 2/11/25. Deficiencies were cited. Based on record review and interview, the facility failed to render services according to the Person-Centered Support Plan (PCSP) as well as, maintain the PCSP on file and ensure it is accessible to all staff, affecting two current (#1, #2) and one former (#4) of four sample members.Specifically, the facility failed to follow the PCSP for former Member #4, which directed the facility to contact a crisis center should the member abuse substances, resulting in the death of the member.Findings include:Former Member #4 was admitted to the facility on 10/1/17 with diagnoses of anogenital herpesviral infection, schizoaffective disorder, anxiety disorder, posttraumatic stress disorder, and sleep deprivation.A care plan, dated 7/12/23, read in part: former Member #4 had a history of alcohol abuse and was stable. He wanted to put himself in a setting that was alcohol-free so that he could continue his sobriety. "If substance abuse occurs staff will contact the Crisis Center immediately."An incident report, dated 10/7/24, read in part: staff attempted to wake former Member #4 at 5:45 a.m. to administer 6:00 a.m. medications. Former Member #4 did not answer. Staff waited 15 minutes and knocked again, but still no answer. Staff retrieved former Member #4' s room key from the medication office. The member was found face down on his bed deceased. Staff contacted the administrator, and then the gene..

A licensure complaint, prompted by #CO39006, was completed on 2/11/25. Deficiencies were cited.A change of ownership occurred on 10/18/23. Based on record review and interview the residence failed to observe the right of a resident to receive services in accordance with the care plan, affecting one former of four sample residents (#4). (Cross-reference S1146)Specifically, the residence failed to follow the care plan for former Resident #4, which directed the residence to contact a crisis center should the resident abuse substances, resulting in the death of the resident.Findings include:Former Resident #4 was admitted to the residence on 10/1/17 with diagnoses of anogenital herpesviral infection, schizoaffective disorder, anxiety disorder, posttraumatic stress disorder, and sleep deprivation.A care plan, dated 7/12/23, read in part: former Resident #4 had a history of alcohol abuse and was stable. He wanted to put himself in a setting that was alcohol-free so that he could continue his sobriety. "If substance abuse occurs staff will contact the Crisis Center immediately."An incident report, dated 10/7/24, read in part: staff attempted to wake for.. Based on record review and interview the residence failed to update a resident' s comprehensive assessment annually and after a condition change from baseline status, affecting one current (#2) of four sample residents and one former resident (#4). (Cross-reference S1360)Findings include:Resident #2 was admitted to the residence on 7/25/24 with diagnoses of alcohol dependence, in remission; other stimulant dependence, uncomplicated; nicotine dependence, unspecified, uncomplicated, and schizoaffective disorder, unspecified.An admission assessment for Resident #2, dated 7/23/24, read in part: "Alcohol History, Sobar - alcohol 2 months; Marijuana History, 3 months; Illegal Drug History, Meth 4-5 months." No other updated comprehensive assessments were provided.An inpatient psychiatric services provider discharge summary, dated 1/8/25, read in part: Resident #2 was under the care of a psychiatric practitioner from 1/1/25 to 1/8/25. She had been discharged to the residence with no limitations or restrictions and new medica.. Based on record review and interview, the residence failed to ensure each resident record contained an individualized resident care plan, affecting two of four sample residents (#1, #2).Findings include:Resident #1 was admitted to the residence on 6/19/24 with a diagnosis of a personal history of traumatic brain injury.A review of Resident #1' s resident record revealed no evidence of a care plan, instead a note was left that read "make care plan".Resident #2 was admitted to the residence on 7/25/24 with diagnoses of alcohol dependence, in remission; other stimulant dependence, uncomplicated; nicotine dependence, unspecified, uncomplicated, and schizoaffective disorder, unspecified.A review of Resident #2' s resident record revealed no evidence of a care plan.On 2/11/25 at 2:30 p.m., the administrator stated that the care plans were completed and in their electronic health record. He stated that he would send them via electronic communication.On 2/11/25 at 4:07 p.m., the administrator wrote via electronic com..

A revisit survey was completed on 8/8/23 for all previous deficiencies cited on 1/25/23. The facility is in compliance with all deficiencies were cited. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally