EMERALD GLEN MEMORY CARE PLUS

Based on record review and interview, the manager failed to ensure a caregiver provided a resident with the assisted living services in the resident's service plan, for two of four residents sampled. The deficient practice posed a risk as a resident did not receive the expected service. Findings include: 1. A review of R1's medical record revealed a current service plan for personal care services dated in June 2023. The plan revealed R1 was to receive showers daily. 2. A review of R1's medical record revealed a "Service Plan Log" dated in September 2023. The document indicated R1 received showers on the following dates: -September 4-6, 2023; -September 12-14, 2023; and -September 18-20, 2023. However, documentation R1 received showers daily was not available for review. 3. In an interview, E2 reported R1 was offered showers daily and would refuse to take showers on some days. 4. A review of R3's medical record revealed a current service plan for directed care services dated in August 2023. The plan revealed R2 was to receive "Bathing" two times weekly. 5. A review of R3's medical record revealed a "Service Plan Log" dated in September 2023. The document indicated R3 received showers on the following dates: -September 4, 2023; -September 14, 2023; and -September 18, 2023. However, documentation R3 received "Bathing" at least two times a week was not available for review. 6. In a joint interview, E1 and E2 acknowledged R1 and R3 had not received the assisted living service documented in R1's and R3's service plans.

Based on record review and interview, the manager failed to ensure a resident's medical record contained documentation of assisted living services provided to the resident, for one of four residents sampled. Findings include: 1. A review of R3's medical record revealed a service plan dated in August 2023 for directed care services. The service plan stated R3 was to receive assistance with "Oral Care" twice a day. However, documentation of "Oral Care" was not available for review on the following dates: -AM Oral Care- September 7-11, 2023 and September 15-17, 2023; and -PM Oral Care- September 7-11, 2023 and September 15-17, 2023. 2. In an interview, E2 reported assisted living services were provided to R3, however, the caregiver who provided the service had not documented the service.

C. In addition to the requirements in R9-10-808(A)(3), a manager shall ensure that the service plan for a resident receiving directed care services includes: 1. The requirements in R9-10-814(F)(1) through (3); 2. If applicable, the determination in R9-10-814(B)(2)(b)(iii); 3. Cognitive stimulation and activities to maximize functioning; 4. Strategies to ensure a resident's personal safety; 5. Encouragement to eat meals and snacks; 6. Documentation: a. Of the resident's weight, or b. From a medical practitioner stating that weighing the resident is contraindicated; and 7. Coordination of communications with the resident's representative, family members, and, if applicable, other individuals identified in the resident's service plan.

Based on record review and interview, the manager failed to ensure a service plan included cognitive stimulation and activities to maximize functioning; and encouragement to eat meals and snacks, for one resident sampled who received directed care services. Findings include: 1. A review of R3's medical record revealed a written service plan dated in August 2023 for directed care services. However, the service plan did not include cognitive stimulation and activities to maximize functioning and encouragement to eat meals and snacks. 2. In a joint interview, E1 and E2 acknowledged R3's service plan did not include cognitive stimulation and activities to maximize functioning and encouragement to eat meals and snacks. Technical assistance was provided on this Rule during the onsite compliance inspection conducted on November 18, 2022.