Rialto House Assisted Living

Based on documentation review, record review, and interview, the manager failed to ensure a caregiver provided evidence of freedom from infectious tuberculosis (TB) on or before the date the individual began providing services at the assisted living facility and as specified in R9-10-113, for one of two personnel sampled. The deficient practice posed a potential illness 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. A review of the facility’s policies and procedures revealed a policy titled "Tuberculosis Screening 28 A.A.R 1113”. The policy stated, “As part of the facility’s pre-employment or resident’s admission process, any individual previously mentioned should present a documentation of evidence of freedom from Tuberculosis either using a two-step Tuberculin Skin Test (TST) or other TB testing recommended by CDC (Baseline Testing) that should be dated within 12 months of start or admission date.” 3. A review of E5’s personnel record revealed a TB skin test that was more than 12 months old. However, after further review, no additional documentation of a second TB test was revealed. 4. In an exit interview, the findings were discussed with E1 and E2 and no additional information was provided.

Based on record review and interview, the manager failed to ensure that the service plan for a resident receiving directed care services included coordination of communications with the resident’s representative, family members, and, if applicable, other individuals identified in the resident’s service plan for one of two residents sampled. Findings include: 1. A review of R1’s medical record revealed a current service plan dated March 9, 2026. The service plan indicated R1 received directed care services. R1’s service plan did not include coordination of communications with the resident’s representative, family members, and, if applicable, other individuals identified in the resident’s service plan. 2. In an exit interview, the findings were discussed with E1 and E2, and no additional information was provided.

Based on record review, observation, and interview, the manager failed to ensure a medication administered to a resident was administered in compliance with a medication order, for one of one resident sampled. The deficient practice posed a risk if the resident experienced a change in condition due to improper medication administration. Findings include: 1. A review of R1's medical record revealed a medication administration record (MAR) dated August 2023. The MAR indicated Modafinil 100 mg was not administered from August 1, 2023-August 4, 2023. 2. A review of R1's medical record revealed a progress note that stated R1 was "out for appointments ...Modafinil was held" on July 31, 2023. 3. A review of R1's medical record revealed a medication order "last modified" on July 1, 2023 for Modafinil 100 mg one tablet by mouth twice per day. 4. The Compliance Officer observed no prescription bottle of Modafinil 100 mg with R1's other medications. 5. In an interview, E3 reported the medication had not been administered to R1 from July 31, 2023-August 4, 2023 because they could not get authorization from R1's medical insurance company to pay for the medication. E3 reported to have contacted R1's power of attorney and the insurance company in attempts to obtain the medication on R1's behalf. These attempts were unsuccessful. E3 acknowledged the attempts to contact R1's power of attorney and the insurance company were not documented.

Based on observation and interview, the manager failed to ensure a fire extinguisher was labeled as rated at least 2A-10-BC by the Underwriters Laboratories was mounted and maintained in the assisted living home. Findings include: 1. During a tour of the facility, the Compliance Officer observed a fire extinguisher sitting on the floor upon entry into the garage. The fire extinguisher was not mounted or labeled as rated at least 2A-10-BC by the Underwriters Laboratories. 2. During a tour of the facility, the Compliance Officer also observed another fire extinguisher mounted to a wall. The fire extinguisher was rated at least 2A-10-BC by the Underwriter Laboratories. 3. In an interview, E2 acknowledged one of the two fire extinguishers was not mounted.