North Valley Care Home

Based on observation, record review, and interview, the manager failed to ensure a bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies was available and accessible in a bedroom being used by a resident receiving personal care services. Findings include: 1. The Compliance Officers observed R3's bedroom did not have a bell, intercom, or other mechanical means to alert the employees to a resident's needs or emergencies. 2. A review of R3's medical record revealed a service plan for personal care services. 3. In an interview, E1 and E2 acknowledged R3's bedroom did not have a bell, intercom, or other mechanical means to alert the employees to a resident's needs or emergencies. .

Based on record review and interview, the manager failed to ensure a medication was administered in compliance with a medication order, for one of three residents reviewed. The deficient practice posed a risk if the resident experienced a change in condition due to improper administration of medication. Findings include: 1. A review of R2's medical record revealed a signed medication list dated September 5, 2023 that included the following medication and instructions: -Lantus 100 Unit. Inject before meals as per sliding scale: 61-200=0 201-250=2 units 251-300=4 units 301-350=8 units 351-400=10 units Greater than 400=12 units and call Doctor. 2. A review of R2's medication administration record (MAR) revealed on November 13, 2023 at 4:00 pm, R2's blood glucose level was recorded as 239. The MAR documentation revealed four units of Lantus was given, however, only two units should have been given per sliding scale. Additionally, on November 14, 2023 for 12:00 pm, R2's blood glucose level was recorded as 329. The MAR documentation revealed ten units of Lantus was given, however, only eight units should have been given per the sliding scale. 3. In an interview, E1 and E2 acknowledged R2 did not receive medication administration for the aforementioned medication in compliance with a medication order.

Based on record review, observation, and interview, the manager failed to ensure a medication administered to a resident was documented in the resident's medical record, for two of three residents reviewed. The deficient practice posed a risk as medication could not be verified as administered against a medication order. Findings include: 1. A review of R1's (received medication administration) medical record revealed a signed medication order dated October 2023, for the following medications: -Quetiapine 100 mg take one tablet daily - Levothyroxine 75 mcg take one tablet daily -Metformin 300 mg take one tablet twice a day 2. A review of R1's medication administration record (MAR) for November 2023, listed the aforementioned medications. However, the MAR did not contain the name and signature of the individual administering the medication for the 5:00 PM administration on November 15, 2023. 3. A review of R2's (received medication administration) medical record revealed a signed medication order dated September 2023, for the following medications: -Tamsulosin 4 mg take one tablet twice a day -Furosemide 80 mg take one tablet once a day -Carvedilol 3.125 mg take one tablet once a day 4. A review of R2's medication administration record (MAR) for November 2023, listed the aforementioned medications. However, the MAR did not contain the name and signature of the individual administering the medication for the 5:00 PM administration on November 15, 2023. 5. In an interview, E1 reported the medications were administered per the medication order and acknowledged R1's and R2's medical records did not include documentation the medications were administered on the above listed days.

Based on observation and interview, the manager failed to ensure a smoke detector was installed in each bedroom. The deficient practice posed a health and safety risk if a smoke detector was needed during an emergency. Findings include: 1. During the facility tour with E1 and E2, the compliance officers observed the smoke detector was missing and had connector wires hanging down from the ceiling in R3's bedroom. 2. During an interview, E1 and E2 acknowledged R3's bedroom did not contain a smoke detector at the time of the survey.