Love and Care III Assisted Living, LLC

Based on record review and interview, the manager failed to ensure a caregiver or assistant caregiver documented the services provided in the resident's medical record, for one of two residents sampled. Findings include: 1. A review of R2's medical record revealed a service plan dated August 1, 2023 for personal care services. The service plan stated the following service was to be provided to R1: "toileting...catheter care empty bag twice a day". 2. A review of R2's medical record revealed an activities of daily living (ADL) document for August 2023. However, the aforementioned service was only documented as being completed once a day. 3. During an interview, E1 acknowledged R2's medical record did not include documentation of the service being provided twice a day. E1 reported the service was provided as indicated in the service plan.