Radiant Care Home

Based on record review and interview, the manager failed to ensure an employee provided documentation of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for two of four caregivers reviewed. The deficient practice posed a potential TB exposure risk to residents. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. Review of the Centers for Disease Control and Prevention website revealed a web page titled "TB Screening and Testing of Health Care Personnel." The web page stated, "If the Mantoux tuberculin skin test (TST) is used to test health care personnel upon hire (preplacement), two-step testing should be used." 3. Review of E3's personnel record revealed a negative TB skin test that was more than 13 months old and no additional documentation of freedom from infectious TB was available for review. Based on E3's hire date, this documentation was required. 4. Review of E4's personnel record revealed a negative TB skin test that was less than 12 months old, however no additional documentation of freedom from infectious TB was available for review. In addition, no documentation of a risk assessment of prior exposure to infectious TB or a determination if E4 had signs or symptoms of TB. Based on E4's hire date, this documentation was required. 5. In an interview, E1 acknowledged E3 and E4 did not provide documentation of freedom from infectious TB as specified in R9-10-113. 6. Technical assistance was provided on this Rule during the compliance inspection conducted November 29, 2022.

Based on record review and interview, the manager failed to ensure a resident provided documentation of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for one of two residents reviewed. The deficient practice posed a TB exposure risk to residents. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. Review of R2's medical record revealed no documentation of a risk assessment of prior exposure to infectious TB or a determination if R2 had signs or symptoms of TB. Based on R2's acceptance date, this documentation was required. 3. In an interview, E1 acknowledged R2 did not provide documentation of a risk assessment of prior exposure to infectious TB or a determination if R2 had signs or symptoms of TB. 4. Technical assistance was provided on this Rule during the compliance inspection conducted November 29, 2022.

Based on record review and interview, the manager failed to ensure a written service plan included a summary of the resident's medical or health problems, including physical, behavioral, cognitive, or functional conditions or impairments, for one of two residents reviewed. The deficient practice posed a risk if medical or health problems were not addressed by the assisted living facility. Findings include: 1. Review of R2's medical record revealed a written service plan for personal care dated August 22, 2023. However, this service plan did not include documentation of R2's medical or health problems. 2. Review of R2's medical record revealed a document dated August 4, 2023 that stated R2 had a diagnosis of "Asthma, Hepatitis, Osteoporosis, Migraines, Obesity, Gastrointestinal Disease, Hyperthyroidism, Osteoarthritis, Pneumonia, and Joint Pain". 3. In an interview, E1 acknowledged R2's service plan did not include documentation of R2's medical or health problems.

Based on record review and interview, the manager failed to ensure the facility did not accept 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, upon acceptance and every six months thereafter, stating 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 one resident reviewed who was confined to a bed or chair. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. Review of R1's medical record revealed a document titled "Determination For Admission" that stated "Is this person confined to a chair or bed and is unable to ambulate on their own" "yes". 2. Review of R1's medical record revealed no documentation indicating R1's medical practitioner examined R1 upon acceptance and every six months thereafter, signed and dated a determination stating R1's needs could be met by the facility, and reviewed the facility's scope of services. 3. In an interview, E1 reported R1 was unable to ambulate even with assistance since acceptance and acknowledged R1's medical practitioner did not provide a written determination upon acceptance and every six months thereafter. 4. This is a repeat deficiency from the compliance inspection conducted November 29, 2022.