Intouch at Highlands LLC

Based on observation, documentation review, and interview, the manager failed to ensure that toxic materials were stored in a locked area and inaccessible to residents. Findings include: 1. During an environmental inspection, the Compliance Officer observed one of the doors underneath the sink slightly open. Opening the cabinet door revealed various cleaning chemicals such as Quick Shine, Windex, Goof Off, Scrubbing Bubbles, Lysol Power Bathroom Foamer, and a can of Raid Ant and Roach. 2. In an interview, E1 acknowledged that poisonous and toxic chemicals were not stored in a locked area and were inaccessible to residents.

Based on observation, documentation, and interview, the manager failed to ensure food was stored free from spoilage, filth, or other contamination and was safe for human consumption. Findings include: 1. During an environmental inspection of the kitchen, the Compliance Officer observed chicken being thawed in the kitchen sink. 2. A review of the facility's policies and procedures revealed a document titled "Infection Control", which stated: "All foods while being stored, prepared and served must be protected from spoilage and contamination and be safe for human consumption. To minimize the likelihood of food borne illness, all Staff engaged in food preparation or service will be required to do the following: a. Store perishable foods properly, such as but not limited to meat, fish, eggs, dairy products, juices at temperatures that will minimize spoilage, i.e. at or below 41° F. b. Thaw frozen foods properly, i.e. in the refrigerator or under cold running water with an unplugged sink." 3. In an interview, E1 acknowledged that food was not stored free from spoilage, filth, or other contamination and was safe for human consumption.

Based on documentation review, record review, and interview, the governing authority failed to ensure compliance with A.R.S. § 36-411, for two of two employees reviewed. Findings include: 1. ARS § 36-411(C)(3-4) states: "C. Each residential care institution, nursing care institution, and home health agency shall make documented, good faith efforts to: [...] (3) Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459. If a potential employee is found to be on the adult protective services registry, the residential care institution, nursing care institution, or home health agency may not hire the potential employee. (4) On or before March 31, 2025, verify that each employee is not on the adult protective services registry pursuant to section 46-459. If an employee is found to be on the adult protective services registry, the residential care institution, nursing care institution, or home health agency shall take action to terminate the employment of that employee." 2. A review of E1 and E2's personnel records revealed no documentation verifying that they were not on the adult protective services registry. 3. In an interview, E1 acknowledged they had not checked the adult protective services registry website.

Based on record review, and interview, the manager failed to ensure that a caregiver documents the services provided in the resident's medical record for two of two residents reviewed. Findings include: 1. A review of R1's medical record revealed activities of daily living (ADL) and current service plan showing various services, including Fluid intake, bathing, oral care, skin care, and incontinence care. A review of ADLs showed no documentation between December 15th and the 18th. 2. A review of R2's medical record revealed activities of daily living (ADL) and current service plan showing various services, including Fluid intake, bathing, oral care, skin care, and incontinence care. A review of ADLs showed no documentation between December 17th and the 18th. 3. In an interview, E1 acknowledged that they had not been keeping up with documentation of ADLs.

Based on observation, record review, and interview, the manager failed to ensure that medication administered to a resident was documented in the resident's medical record for two of the two residents reviewed. Findings include: 1. While the Compliance Officer was reviewing documents, they observed E1 filling out the medication administration record (MAR). 2. During the inspection, the Compliance Officer observed E1 provide medication to residents. 3. A review of R1's medical record revealed current medication orders listing various medications such as, Acetaminophen 325 mg z 2 tabs PO Q 6hrs, Clonazepam 1mg1 tab PO BID, Amlodipine 5mg 1 tab PO QD, Venlafaxine 150mg1 cap PO QD, Alendronate sodium 70mg 1 tab orally, every Sunday, Olanzapine 10mg 1 tab PO QD, Maltrexone 50mg 1 Tab PO Qd, Seroquel 25mg 1 tab PO QD. A review of December's MAR revealed no documentation between the 15th and 19th. 4. A review of R2's medical record revealed current medication orders listing various medications such as, Glipizide 5 mg 1 tab PO QD, Famotide 20 mg 1 tab PO BID, HYDROxyzine HCL-100mg 1 tab PO BID, Amlodipine 10 mg 1 tab PO QD, Losartan 100mg1 tab PO QD, Tamsuosin HC 0.4 mg 1 cap PO QD, Metoprolol -50mg 1 tab PO QD, Metforminn 500 mg 2 tabs BID, Gabapentin 800 mg 1 tab PO BID. A review of December's MAR revealed no documentation between the 17th and 19th. 5. In an interview, E1 acknowledged that they have not been documenting medication that was being administered, and they had been filling out the MAR from the days before. E1 reported that the medication was given to all residents.