Morningstar at Applewood

A relicensure and complaint revisit was completed on 12/30/24 for all previous deficiencies cited on 8/22/23. The residence is in compliance with all regulations surveyed. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A revisit survey was completed on 3/6/24 for all previous deficiencies cited on 10/19/23. The facility is in compliance with all deficiencies that were cited. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A licensure complaint, prompted by #CO33838, was completed on 10/19/23. Deficiencies were cited. Based on observation and interview, the residence failed to make weekly menus readily available for residents and public viewing no less than 24 hours prior to serving, affecting 81 current residents. Findings include:On 10/19/23 at 11:44 a.m. to 11:54 a.m., observations throughout the residence revealed there were no menus readily available for resident and public viewing anywhere in the residence.On 10/19/23 at 11:29 a.m. Resident #42 stated there were other menus than the one they put out for the day but staff did not mention the other menus to the residents.On 10/19/23 at 4:29 p.m. the administrator stated the weekly menus were not posted for residents to view. She added that she was aware that the menus should be posted 24 hours prior to serving for residents to view. Based on record review and interview, the residence failed to ensure residents received the maximum degree of benefit from services made available by the residence, affecting one of four sample residents (#39).Findings include:1. Residence Policiesa. The residence' s Resident Rights Policy, dated July 2021, read, in part, "Residents are treated in a manner that preserves their dignity, autonomy, self-esteem, rights and involvement in their own care ... When providing care and services, staff will respect each resident' s individuality, as well as honor and value their input."b. The residence' s resident agreement, dated January 2020, read, in part, "Resident Rights Colorado ... Consistent with Colorado law, the resident shall have the following rights ... The right to choice and personal involvement regarding .. Based on record review and interview, the residence failed to ensure that before a personal care worker independently performed personal services for a resident, the supervisor designated by the residence documented that the worker had demonstrated his or her ability to completely perform every personal task assigned, affecting two of two sample staff (#33, #34). Findings include:1. ReferencesRegulations governing assisted living residences, part 2.33, defines "Personal care worker" as an individual who: (A) Provides personal services for any resident.Regulations governing assisted living residences, part 7.12, requires that each personnel file shall include, but not be limited to, written documentation regarding the following items:(C) Orientation and training, including first aid and CPR certific.. THIS PORTION OF THE REPORT IS FOR INFORMATIONAL PURPOSES ONLY. No response is necessary. The residence was advised it must review and maintain the following processes in accordance with existing program regulations found at 6 CCR 1011-1, Chapter 7.11.5 The assisted living residence shall review its resident agreements annually and update or amend them as necessary. Amendments to the resident agreement shall also be signed and dated by both parties.(A) When a change of ownership occurs, the new owner shall either acknowledge and agree to the terms of each existing resident agreement or establish a new agreement with each resident.

A relicensure survey with complaints #CO32479, #CO32605, #CO33103, #CO33116, was completed on 8/22/23. Deficiencies were cited. Based on interview and record review, the residence failed to contact the resident' s practitioner when the resident had physical signs of possible infection (open sores, etc.), affecting one former resident (#15).Findings include:1. References and Residence PolicyChapter VII regulations governing assisted living residences, part 2.21, defines "Exter.. Based on observation and interview, the residence failed to ensure all bathtubs/shower floors had proper safety features to prevent slips and falls, affecting eight of 12 sample residents (#17, #18, #23-#26, #28, #29).Findings include: On 8/22/23 from approximately 8:00 a.m. to 12:00 p.m., an environmental tour of Resident #17, #18, #23-#.. Based on observation and interview, the residence failed to ensure resident rooms occupied by smokers had fire resistant wastebaskets, affecting two of three sample residents (#34, #35) who smoked cigarettes.Findings include:A list of residents who smoked was provided by the residence. Resident #34 and #35 were identified as residents who s.. Based on observation, interview and record review, the residence failed to update the comprehensive assessment when the resident' s condition changed from baseline status, affecting one sample resident (#30) who experienced a change in their baseline status. Findings include:1. References and Residence Policya. Chapter VII regulations governi.. Based on observation, record review and interview, the residence failed to ensure qualified medication administration persons (QMAPs) followed national recognized protocols for basic infection control and prevention when preparing and administering medications, affecting five of five sample residents (#27, #28, #31-#33) during medication administrati.. Based on observation, record review, and interviews, the residence failed to place in a visible location a list of all staff who had current certification in first aid or cardiopulmonary resuscitation (CPR), affecting 84 current residents. Findings include: The residence' s cardiopulmonary resuscitation (CPR) response policy and procedure, dated July 202.. Based on record review and interview, the residence failed to ensure residents in a secure environment had an enhanced care plan that contained the required information, affecting one of three sample residents (#11) who resided in the secure environment.Findings include:1. References and Residence Policya. Chapter VII regulations gov.. Based on record review and interview, the residence failed to ensure that only medication ordered by an authorized practitioner was prepared for or administered to residents, affecting two of eleven sample residents (#11, #23). (Cross-reference Q1514)Findings include:1. Resident #11 was admitted to the residence on 8/11/21.The August 2023 .. Based on record review and interview, the residence failed to ensure the administrator and the qualified medication administration supervisor (QMAP) audited, on a quarterly basis, the accuracy and completeness of the medication administration records, controlled substance lists, medication error reports, and medication disposal records, affecti.. THIS PORTION OF THE REPORT IS FOR INFORMATIONAL PURPOSES ONLY.No response is necessary.The residence was advised it must review and maintain the following processes in accordance with existing program regulations found at 6 CCR 1011-1, Chapter 7.17.14 Staff who assist feeding a resident shall be trained in the proper techniques for suppo..

A licensure revisit was completed on 3/14/23 for all previous deficiencies cited on 3/31/22. Deficiencies were cited. Based on observation, interview and record review, the residence failed to ensure residents had the right to be treated with dignity and respect, affecting four of six sample residents (#15-#18) who resided in the secure environment. Findings include:1. Residence policyThe residence' s undated Resident Rights policy read, in part, residents had the right to be treated with respect and dignity.2. ObservationsOn 3/13/23 from 7:19 a.m. to 7:37 a.m., the following was observed in the secure environment:Staff #19 said to Resident #16: "Hi sweetheart"Staff #19 said to Resident #15: "The food will be here soon sweetie"Staff #19 said to Resident #18: "Okay sweetie"Staff #19 said to Resident #17: "Okay sweetie" and "You' re so cute. Okay sweets?"3. InterviewsOn 3/13/23 at 7:45 a.m., Staff #19 state.. Based on observation, record review and interview, the residence failed to comply with conditions imposed by the department on the license, affecting 95 current residents. Findings include:1. RecordsDepartment records read the residence was currently required to retain a registered nurse (RN) consultant for six months. Following the completion of Event YBWY11 on 6/15/22, a complaint investigation, the department imposed a nurse consultant for six months to address the cited deficiencies and to also ensure compliance with all other pertinent regulations. The intermediate condition read the nurse consultant was required to complete, during the first month of the contract period:- Review each of the cited deficiencies identified in the Deficiency List, for Event YBWY11 and dated June 15, 2022, with the .. Based on record review and interview, the residence failed to comply with the authorized practitioner orders associated with medication administration, affecting six of seven sample residents (#11, #12, #14-#17).This deficiency was cited previously during a licensure complaint survey on 3/31/22. Although the residence corrected the deficiency, based on the findings below, the residence has not maintained compliance with this regulatory requirement.1. Residence PolicyThe residence' s Medication and Medication Administration policy, dated July 2021, read in part, "all medication orders will be documented in writing by an authorized prescribing practitioner. Verbal orders for medication will not be valid unless received by a licensed team member who is authorized to receive and transcribe .. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A licensure complaint, prompted by #CO30889 was completed on 3/14/23. Deficiencies were cited. Based on interview and record review, the residence failed to ensure each qualified medication administration person (QMAP) accurately documented each medication administration event at the time the event was completed for each .. Based on observation, interview and record review, the residence failed to ensure controlled substances medications were kept in a separate locked container until destroyed, affecting one sample resident (#19).Findings include:1. Res.. Based on observation, interview and record review, the residence failed to ensure residents had the right to be treated with dignity and respect, affecting four of six sample residents (#15-#18) who resided in the secure environm.. Based on observation, record review and interview, the residence failed to comply with conditions imposed by the department on the license, affecting 95 current residents. Findings include:1. RecordsDepartment records read the r.. Based on observation, record review and interviews, the residence failed to request, prior to staff hire, a name-based criminal history record check for each prospective staff member, for one of four sample staff (#18), affecting 95 curr.. Based on observations, interviews and record review, the residence failed to implement and follow their policy pertaining to fall management which included detailing in the resident' s care plan the individualized approaches nec.. Based on record review and interview, the residence failed to comply with the authorized practitioner orders associated with medication administration, affecting six of seven sample residents (#11, #12, #14-#17).1. Residence .. Based on record review and interview, the residence failed to develop and implement policies and procedures regarding the hiring of any staff member whose criminal history records did not reveal good, moral, and responsible .. Based on record review and interview, the residence failed to ensure staff files included written documentation regarding a description of the employee duties, date of hire, orientation, training documentation, results of backgro.. Based on record review and interview, the residence failed to implement a policy for an effective information management system that allowed effective continuity of care which included a method of integration for both paper.. Based on record review and interview, the residence failed to show compliance with Colorado Adult Protective Services Data System (CAPS Check) requirements, affecting 95 current residents.Findings include:1. Referencesa. Acc.. Based upon observations, interviews and record review, the residence failed to ensure residents received the cooperation in achieving the maximum degree of benefit from those services made available by the residence, affect..