Scottsdale Palms Assisted Living LLC

Based on record review and interview, the manager failed to ensure a service plan included documentation of the resident's weight or documentation from a medical practitioner stating weighing the resident was contraindicated, for one of one resident sampled receiving directed care services. The deficient practice posed a health and safety risk to the residents. Findings include: 1. A review of R1's medical record revealed R1 received directed care services. 2. A review of R1's service plan dated May 8, 2024 revealed no documentation of R1's weight. In addition, R1's medical record revealed no documentation of R1's weight or documentation from a medical practitioner stating weighing R1 was contraindicated. 3. In an interview, E1 acknowledged R1's service plan did not include documentation of R1's weight and documentation was not available in R1's medical record from a medical practitioner stating weighing R1 was contraindicated.

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 facility obtained a written determination from a medical practitioner, every six months, that stated 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 two residents sampled. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. A review of R1's service plan (dated May 8, 2024) revealed R1 received directed care services and was non-ambulatory. 2. A review of R1's medical record revealed documentation of a determination of continued residency dated May 16, 2023. No further documentation was available for Compliance Officer review. 3. In an interview, E1 acknowledged that R1's medical record did not contain a written determination from a medical practitioner, updated every six months.