Tramonto Assisted Living

Based on observation, record review, documentation review, and interview, the governing authority failed to designate, in writing, a manager who either had a certificate as an assisted living facility manager issued under Arizona Revised Statutes (A.R.S.) \'a7 36-446.04(C), or a temporary certificate as an assisted living facility manager issued under A.R.S. \'a7 36-446.06. Finding include: 1. During the environmental inspection of the facility, the Compliance Officer observed E1's manager's license conspicuously posted in the facility. 2. A review of E1's personnel record revealed a manager's license with an expiration date of June 30, 2023. 3. A review of the Board of Examiners for Nursing Care Institution Administrators and Assisted Living Facility Managers (NCIA Board) website reflected E1's license was issued April 4, 1996 and expired on June 30, 2023. 4. In an interview, E1 reported being unaware E1's manager's license was expired.

Based on record review, observation, and interview, the manager failed to ensure medication administered to a resident was administered in compliance with a medication order, for one of two sampled residents. Findings include: 1. A review of R1's medical record revealed a service plan dated September 9, 2023, which reflected R1 received medication administration services. 2. A review of R1's medical record revealed a medication administration record (MAR) dated December 2023. R1's December 2023 MAR documented R1 was administered "Rosuvastatin 10 mg (milligrams) one tablet at 8 pm" from December 1, 2023 to December 5, 2023. 3. The Compliance Officer observed R1's medications, which included "Rosuvastatin". 4. In an interview, E1 reported being unaware a medication order for "Rosuvastatin" was not included in R1's medical record. No medication order for "Rosuvastatin" was provided for review at the time of the survey.