Legend Ddd Services - Emerita Nsgh

Based on documentation, record review, and interview, the facility failed to maintain a standardized form for each resident that included the information prescribed in A.R.S. 36-420.04.A. Findings include: 1. A.R.S. 36-420.04.A states, "A. An assisted living center or assisted living home that contacts an emergency responder on behalf of a resident shall provide to the emergency responder a written document that includes all of the following: 1. The reason or reasons the emergency responder was requested on behalf of the resident. 2. Whether the resident receives medication services and, if the resident has provided this information to the assisted living center or assisted living home, a list of all the resident's prescription and over-the-counter medications, their dosages and how frequently they are administered. 3. The name, address and telephone number of the resident's current pharmacy. 4. A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive. 5. The name and contact information for the resident's primary care physician and power of attorney or authorized representative. 6. Basic information about the resident's physical and mental conditions and basic medical history, such as having diabetes or a pacemaker or experiencing frequent falls or cardiovascular and cerebrovascular events, as well as dates of recent episodes, if known. 7. The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address. A point of contact must be available to respond to questions regarding the information provided twenty-four hours a day, seven days a week. 8. A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge. This paragraph does not preclude a resident from revoking the resident's health insurance portability and accountability act release authorization. 9. A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home. This paragraph does not preclude a resident from revoking or modifying the resident's advance directives." 2. A review of R1's and R2's medical records revealed a standardized form which failed to include a copy of the residents health insurance portability and accountability act (HIPAA) release for R1 and R2. 3. In an interview, E1 acknowledged the facility failed to maintain a standardized form for each resident that included the information prescribed in A.R.S. 36-420.04.A.

Based on observation, documentation review, record review, and interview, the administrator failed to ensure a personnel member's skills and knowledge were verified and documented before the personnel member provided physical health services, habilitation services, or behavioral care, for three of three personnel members sampled. The deficient practice posed a risk if the employees were unable to meet a resident's needs. Findings include: 1. During an environmental tour of the facility, the Compliance Officers observed E2, E3, and E4 providing services and interacting directly with residents. 2. A review of the facility's policies and procedures revealed a policy titled "Personnel Hiring & Training Plan: Direct Service Personnel Skill Competency." The policy stated, "Assessment and Evaluation: Within the first 7 days of employment, all direct service personnel will complete a Direct Service Position (DSP) Skills Competency Assessment." 3. A review of E2's, E3's, and E4's personnel record revealed a form titled, "Personnel Skills Competency." The form indicated E2, E3, and E4 had completed the skills check, however, the form was not signed by the facility administrator or registered nurse (RN) as required. The facility administrator and RN signed the form during the course of the inspection. 4. In an interview, E1 acknowledged E2's, E3's, and E4's skills and knowledge were not verified before the personnel provided physical health services, habilitation services, or behavioral care.