Litchfield Joy Senior Living LLC

Based on record review and interview, the manager failed to ensure a caregiver provided current documentation of first aid and cardiopulmonary resuscitation (CPR) training that included a demonstration of the individual's ability to perform CPR, before providing assisted living services, for one of three caregivers. The deficient practice posed a risk if an employee was unable to meet a resident's needs during an emergency. Findings include: 1. Review of E3’s personnel record revealed E3 worked as a caregiver five days a week for the day shift. 2. The personnel record for E3 revealed a CPR card that was obtained from NationalCPRFoundation issued on November 17, 2023, and valid for two years. There was no other current documentation of CPR training available for review. 3. In a telephone call, a representative from NationalCPRFoundation stated, "Our courses are online only." 4. In an interview, E2 acknowledged E3 did not have current documentation of first aid and CPR training, which included a demonstration of the individual's ability to perform CPR.

Based on interview and record review, the manager failed to ensure the facility did not accept or retain a resident who was confined to a bed or chair because of an inability to ambulate even with assistance, unless the facility obtained a written determination from a medical practitioner, every six months, that stated the resident's needs could be met by the facility and the resident's needs were within the facility's scope of services, for one of two residents sample review. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. In an interview, E2 reported R2 was non-ambulatory and received Directed Care Services. 2. A review of R2's medical record revealed a service plan dated August 12, 2025. The service plan stated, "Resident is bed bound and does not ambulate." 3. A review of R2's medical record revealed no documentation indicating R2's medical practitioner examined R2 every six months, signed and dated a determination that stated R2's needs could be met by the facility, and reviewed the facility's scope of services. 4. In an interview, E2 acknowledged that R2’s medical practitioner did not provide a written determination at least once every six months, as required.

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 dated within 90 calendar days before the individual is accepted by an assisted living facility stating whether the individual required intermittent nursing services or restraints, for two of three residents reviewed. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. Review of R1's and R3's medical records revealed documents titled "Preliminary Admission Data/Primary Care Provider" were not dated within 90 calendar days before acceptance to the assisted living facility. 2. Review of R1's and R3's medical records revealed a document titled "Preliminary Admission Data/Primary Care Provider". The documents included documentation indicating R1 and R3 did not require continuous medical services, continuous nursing services, intermittent nursing services, or restraints; however, R1 and R3 required intermittent nursing services. 3. In an interview, E1 reported that R1 received home health services and R3 received hospice services. 4. In an interview, E1 acknowledged documentation signed by a medical practitioner or a registered nurse was not dated within 90 calendar days before R1 and R3 were accepted to the facility and documentation did not state that R1 and R3 required intermittent nursing services.

Based on interview and record review, the manager failed to ensure a resident's medical record contained a medication order from a medical practitioner for each medication administered to the resident, for one of three residents sampled. The deficient practice posed a risk as administered medication could not be verified against a medication order. Findings include: 1. The Compliance Officer observed a bottle of Midorine 2.5 mg in R1's medication box with a label that instructed the medication to be given three times a day. 3. A review of R1's medical record revealed a signed medication order dated on October 1, 2024 for Midorine 2.5 mg that instructed the medication to be given twice a day. 4. A review of R1's Medication Administration Record (MAR) documented that Midorine 2.5 mg was administered to R1 three times a day. 4. In an interview, E1 acknowledged R1's medical record did not contain an updated medication order for each medication being administered for R1.

Based on observation and interview, the manager failed to ensure a toxic material stored by the facility was stored in a locked area and inaccessible to residents. The deficient practice posed a risk to the physical health and safety of residents with access to the materials. Findings include: 1. During the environmental inspection of the facility, the Compliance Officer observed "Ajax", aerosol "Lysol" and wipes, and other toxic cleaning supplies in a cabinet underneath the kitchen sink. The cabinet was unlocked and was accessible to residents. 2. During the environmental inspection of the facility, the Compliance Officer observed a bottle of "Fabuloso" cleaner in the laundry room. The laundry room door was unlocked and was not alarmed. 3. In an interview, E2 acknowledged toxic materials stored by the facility were not stored in a locked area and inaccessible to residents.