Lovecare Co

Based on record review and interview, the manager failed to ensure a resident's service plan was documented and updated at least once every three months, for one of one sampled resident receiving directed care services. Findings include: A review of R2's medical record revealed a service plan update, dated June 2, 2025, for Directed Care services. However, service plan updates, dated on or before September 2025 and December 2025, were not available for review. In an interview, E1 reported R2's service plan had been updated earlier in the week and had been misplaced. E1 attempted to locate the updated service plan during the on-site inspection, but was not able to provide the updated service plan during the inspection. In an interview with E1, the findings were reviewed and no additional information was provided.

Based on record review and interview, the manager failed to ensure a caregiver documented the services provided in each resident's medical record, for two of two sampled residents. Findings include: A review of R1's medical record revealed a document titled "A.D.L. Flow Sheet" (ADL) dated February 2026. The ADL documented the services provided to R1 on each day in February 2026, between February 1, 2026, and the date of the inspection, February 13, 2026. However, the form had been left blank on February 1, 3, 6, 7, and February 8, 2026. A review of R2's medical record revealed a document titled "A.D.L. Flow Sheet" (ADL) dated February 2026. The ADL documented the services provided to R2 on each day in February 2026, between February 1, 2026, and the date of the inspection, February 13, 2026. However, the form had been left blank on February 1, 3, 6, 7, and February 10, 2026. In an exit interview with E1, the findings were reviewed and no additional information was provided.

Based on record review and interview, the manager failed to ensure a medication administered to a resident was documented in the resident's medical record, for two of two sampled residents. Findings include: A review of R1's medical record revealed a Medication Administration Record (MAR), dated February 2026. The MAR documented the medications administered to R1 during the month of February 2026, between February 1 and the date of the on-site inspection, February 13, 2026. However, the MAR had been left blank on February 1, 3, 6, 7, 8, and February 10, 2026. A review of R2's medical record revealed a Medication Administration Record (MAR), dated February 2026. The MAR documented the medications administered to R2 during the month of February 2026, between February 1 and the date of the on-site inspection, February 13, 2026. However, the MAR had been left blank on February 1, 3, 6, 7, 8, and February 10, 2026. In an exit interview with E1, the findings were reviewed and no additional information was provided.

Based on record review and interview, 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 resident or resident's representative requested the resident remain in the facility and the facility obtained a written determination from a medical practitioner every six months stating they have examined the resident and the resident's needs were met by the facility and the resident's needs were within the facility's scope of services, for one of one residents reviewed who were confined to a bed or chair. The deficient practice posed a health and safety risk to the resident if the facility retained a resident who was confined to a bed or chair and the resident's needs were not met. Findings include: 1. A review of R2's (admitted in 2020)medical record revealed a current service plan for directed care services which indicated R2 was bedbound. Further review of R2's medical record revealed a document titled, "Determination for Residency to Continue in the Facility," dated March 2, 2020. The document read, "The resident is unable to ambulate even wit assistance and is confined to a bed or a chair." The document included a section for R2's or R2's Representative signature, however the section was blank. The document also included a section, signed by a primary care provider (PCP), which indicated the PCP had examined R2, reviewed the facilities Scope of Services and made a determination R2's needs could be met by the facility. However, evidence R2 had been examined every six months by a medical provider who determined R2's needs could be met by the facility was unavailable for review. Based on R2's date of admission, this documentation was required. 4. In an interview, E1 reported R2 was non-ambulatory. E1 acknowledged R2's medical record did not include the required documentation to retain a resident who was confined to a bed or chair because of an inability to ambulate even with assistance.

Based on documentation review, record review, and interview, the the health care institution failed to develop and administer a training program for all staff regarding fall prevention and fall recovery. The deficient practice posed a risk as the Department was unable to determine substantial compliance as the documentation was not provided during the inspection, and the licensee did not provided the documentation at the exit interview. Findings include: 1. A review of facility documentation revealed information realted to fall prevention and recovery in an assisted living home, however, the information did not include a program for continued competency in fall prevention and fall recovery. 2. In an interview, E1 acknowledged a training program ensuring continued competency for all staff in fall prevention and fall recovery had not been developed and administered.

Based on record review, documentation review, and interview, the governing authority failed to ensure compliance with A.R.S. \'a7 36-411, for one of three employees sampled. The deficient practice posed a risk if E4 was a danger or immediate threat to vulnerable populations. A.R.S. \'a7 36-411.E states: "Except as provided in subsection F of this section, a residential care institution, nursing care institution or home health agency shall not allow an employee to continue employment or a contracted person to continue to provide medical services, nursing services, behavioral health services, health-related services, home health services or supportive services if the person has been denied a fingerprint clearance card pursuant to title 41, chapter 12, article 3.1 or has been denied approval pursuant to this section before May 7, 2001." Findings include: 1. The Compliance Officer observed E4 working in the facility on May 4, 2023. 2. A review of E4's (hire date March 2, 2023) personnel record revealed no documentation of a valid fingerprint clearance card. 3. A review of E4's personnel record revealed a letter from the Arizona Department of Public Safety dated April 21, 2023 advising E4 that E4's application for a fingerprint clearance card had been denied. 4. A review of E4's personnel record revealed evidence of filing a good cause exemption form was not available for review. 5. In an interview, E4 reported they were in the process of acquiring the necessary paperwork in order to file their good cause exception. E4 acknowledged their application for fingerprint card clearance card had been denied and they had not filed the application for good cause exception. 6. In an interview, E1 acknowledged E4 was working at the facility after E4 had been denied a fingerprint clearance card.

Based on record review, documentation review, and interview, the manager failed to ensure a manager, a caregiver, and an assistant caregiver provided evidence of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for one of three caregivers sampled. Findings include: 1. A review of E4's personnel record revealed a document titled, "Record of Tuberculin Skin Test." The document indicated the test was administered on March 1, 2023, however the document indicated the test was also read on March 1, 2023. No additional evidence of documentation of freedom from infectious TB was avaiable for review. 2. In an interview, E1 acknowledged current documentation of evidence of freedom from TB was not available for E4.

Based on observation and interview, the manager failed to ensure that medication was stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage. Findings include: 1. During a tour of the facility the Compliance Officer observed a secretary desk in the dining room. The desk included a cabinet with glass doors on top, drawers below and between a hinged panel that dropped down to become a writing surface. The panel had a locking mechanism, however it was not secured and the Compliance Officer was able to open the panel. Inside were many cubbies containing various stationary items, however one cubbie contained a bottle of "Adult Robitussin Maximum Strength Nighttime Cough DM." 2. In an interview, E2 reported the medication in the secretary desk had not been stored in a separate locked room, cabinet or self-contained unit the facility uses for medication storage. E2 removed the medication from the desk and stored it in a locked closet used for medication storage.

Based on observation and interview the manager failed to ensure food was stored free from spoilage and was safe for human consumption. Findings include: 1. During a tour of the facility the Compliance Officer observed a jar of "Tostitos Salsa con Queso" in the refrigerator. The jar was marked with an expiration date of "FEB 2023 2." Also observed was a bottle of "Beaver Brand Honey Mustard" with a "Best By" date of "NOV 7 2022." 2. In a cabinet in the dining room, the Compliance Officer observed a bottle of "Organic Maple Syrup," which had been opened. The bottle had a best by date of November 28, 2024, however the label indicated "Refrigerate After Opening." 3. In an interview, E2 acknowledged the "salsa con queso" and honey mustard had passed their expiration and best by dates, and the syrup had not been refrigerated after it was opened. E2 disposed of the items in the trash.