The Meadows of Prescott Valley LLC

Based on record review and interview, the manager failed to ensure there was a documented residency agreement with the assisted living facility that included terms of occupancy, including the date of occupancy or expected date of occupancy, for eight of nine total residents. The deficient practice posed a risk as required information could not be verified. Findings include: 1. A review of R1's medical record revealed a residency agreement. However, the residency agreement did not include R1's date of occupancy or expected date of occupancy. 2. A review of R2's medical record revealed a residency agreement. However, the residency agreement did not include R2's date of occupancy or expected date of occupancy. 3. A review of R4's medical record revealed a residency agreement. However, the residency agreement did not include R4's date of occupancy or expected date of occupancy. 4. A review of R5's medical record revealed a residency agreement. However, the residency agreement did not include R5's date of occupancy or expected date of occupancy. 5. A review of R6's medical record revealed a residency agreement. However, the residency agreement did not include R6's date of occupancy or expected date of occupancy. 6. A review of R7's medical record revealed a residency agreement. However, the residency agreement did not include R7's date of occupancy or expected date of occupancy. 7. A review of R8's medical record revealed a residency agreement. However, the residency agreement did not include R8's date of occupancy or expected date of occupancy. 8. A review of R9's medical record revealed a residency agreement. However, the residency agreement did not include R9's date of occupancy or expected date of occupancy. 9. In an interview, E1 and E2 reported the aforementioned residency agreements did not contain the residents' date of occupancy or expected date of occupancy. Technical assistance was provided on this rule during the compliance inspection conducted on December 1, 2021.

Based on record review, interview, and observation, the manager failed to ensure a caregiver or an assistant caregiver documented the services provided in the resident's medical record, for seven of nine total residents. The deficient practice posed a risk as services could not be verified as provided against a service plan. Findings include: 1. A review of R1's medical record revealed a service plan dated January 24, 2023. The service plan revealed R1 was to receive the service of "COMB HAIR Daily." The review revealed two "ACTIVITIES OF DAILY LIVING FLOWSHEET[S] (ADL flow sheets)" dated May 2023 and June 2023 respectively. However, the documents did not include documentation of hair care provided to R1 nor did the documents include a space to document hair care. 2. A review of R2's medical record revealed a service plan dated March 31, 2023. The service plan revealed R2 was to receive the service of "COMB HAIR Twice Daily." The review revealed two ADL flow sheets dated May 2023 and June 2023 respectively. However, the documents did not include documentation of hair care provided to R2 nor did the documents include a space to document hair care. 3. A review of R3's medical record revealed a service plan dated April 21, 2023. The service plan revealed R3 was to receive the service of "COMB HAIR Daily." The review revealed two ADL flow sheets dated May 2023 and June 2023 respectively. However, the documents did not include documentation of hair care provided to R3 nor did the documents include a space to document hair care. 4. A review of R4's medical record revealed a service plan dated March 26, 2023. The service plan revealed R4 was to receive the service of "COMB HAIR Twice Daily." The review revealed two ADL flow sheets dated May 2023 and June 2023 respectively. However, the documents did not include documentation of hair care provided to R4 nor did the documents include a space to document hair care. 5. A review of R5's medical record revealed a service plan dated December 20, 2022. The service plan revealed R5 was to receive the service of "COMB HAIR Daily." The review revealed two ADL flow sheets dated May 2023 and June 2023 respectively. However, the documents did not include documentation of hair care provided to R5 nor did the documents include a space to document hair care. 6. A review of R6's medical record revealed a service plan dated March 26, 2023. The service plan revealed R6 was to receive the service of "COMB HAIR Daily." The review revealed two ADL flow sheets dated May 2023 and June 2023 respectively. However, the documents did not include documentation of hair care provided to R6 nor did the documents include a space to document hair care. 7. A review of R7's medical record revealed a service plan dated April 22, 2023. The service plan revealed R7 was to receive the service of "COMB HAIR Daily." The review revealed two ADL flow sheets dated May 2023 and June 2023 respectively. However, the documents did not include documenta