ANGEL'S SENIOR CARE LLC

B. A manager of an assisted living facility authorized to provide personal care services may accept or retain a resident who is confined to a bed or chair because of an inability to ambulate even with assistance if: 2. The following requirements are met at the onset of the condition or when the resident is accepted by the assisted living facility: b. The resident's primary care provider or other medical practitioner: i. Examines the resident at the onset of the condition, or within 30 calendar days before acceptance, and at least once every six months throughout the duration of the resident's condition;

Based on record review and interview, the manager retained a resident without meeting the requirements in R9-10-814(B)(2), at least once every six months throughout the duration of the resident's condition, for one resident sampled who was confined to a bed or chair because of an inability to ambulate even with assistance and received personal care services. 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 medical record revealed a service plan (dated in June 2023) for personal care services. The service plan stated "Mobility... wheelchair... bedbound..." 2. A review of R1's medical record revealed a document titled "Approval for Continued Residency." The form was signed by a medical practitioner in August 2022. However, documentation of an examination at least once every six months signed and dated by the resident's primary care provider or other medical practitioner was not available for review. 3. In an interview, E1 acknowledged the examination required from the resident's primary care provider or other medical practitioner every six months during R1's residency was not available for review.

Based on record review and interview, the manager retained a resident without meeting the requirements in R9-10-814(B)(2)(b)(i-ii), at least once every six months throughout the duration of the resident's condition, for one resident sampled who was confined to a bed or chair because of an inability to ambulate even with assistance and received directed care services. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: R9-10-814(B)(2) A manager of an assisted living facility authorized to provide personal care services may accept or retain a resident who is confined to a bed or chair because of an inability to ambulate even with assistance if: b. The resident's primary care provider or other medical practitioner: i. Examines the resident at the onset of the condition, or within 30 calendar days before acceptance, and at least once every six months throughout the duration of the resident's condition; ii. Reviews the assisted living facility's scope of services; 1. A review of R2's medical record revealed a service plan (dated in August 2023) for directed care services. 2. In an interview, E1 and E3 reported R2 was chairbound. 3. A review of R2's medical record revealed a document titled "Approval of Continued Residency." The form was signed by a medical practitioner in February 2023. However, documentation of an examination at least once every six months signed and dated by the resident's primary care provider or other medical practitioner was not available for review. 4. In an interview, E1 acknowledged the examination required from the resident's primary care provider or other medical practitioner every six months during R2's residency was not available for review.