FIVE ROSES ADULT CARE HOME III

Based on record review and interview, the manager failed to ensure a personnel record for each employee or volunteer included documentation of evidence of freedom from infectious tuberculosis (TB), if required for the individual according to subsection (A)(8), for one of three caregivers sampled. The deficient practice posed a TB exposure risk to residents. Findings include: 1. A review of E3's personnel record revealed documentation of evidence of freedom from infectious TB was not available for review. 2. In an interview, E1 reported E3 had current documentation of evidence of freedom from infectious TB. However, the documentation was not provided for review during the inspection or during the exit interview.

Based on record review and interview, the manager failed to ensure a resident's medical record contained documentation of the refusal to be immunized for influenza (flu) and pneumonia, for one of three residents sampled. Findings include: A.R.S. \'a7 36-406(1)(d) The department shall: Require as a condition of licensure that nursing care institutions and assisted living facilities make vaccinations for influenza and pneumonia available to residents on site on a yearly basis. The department shall prescribe the manner by which the institutions and facilities shall document compliance with this subdivision, including documenting residents who refuse to be immunized. 1. A review of R2's medical record revealed documentation of notification of the availability of vaccination for flu and pneumonia vaccination dated in 2020. However, documentation of the notification for the flu and pneumonia vaccinations available to R2 on site on a yearly basis was not available for review. 2. In an interview, E1 reported R2 declined vaccinations. E1 acknowledged documentation of R2's refusal to be immunized for flu and pneumonia on a yearly basis was not available for review. Technical assistance was provided on this Rule during the onsite compliance inspection completed on July 21, 2022.

Based on record review and interview, the manager failed to ensure if a verbal order for a resident's medication is received from a medical practitioner by the assisted living facility the verbal order is documented in the resident's medical record, for two of three residents sampled. Findings Include: 1. A review of R1's medical record revealed a medication administration record (MAR) for August 2023. The MAR documented Trazadone 50 mg was administered once a day at bedtime on August 1-2, 2023. 2. A review of R1's medical record revealed a medication order for Trazadone 50 mg tablet, one tab every night at bedtime as needed for Insomnia. 3. In an interview, E1 reported Trazadone had recently been changed from being taken as needed to being taken every day. E1 acknowledged a verbal order was not documented in the resident's medical record. 4. A review of R2's medical record revealed a MAR for August 2023. The MAR documented Levothyroxine 100 mcg was administered once a day in the mornings on August 1-3, 2023. 5. A review of R2's medical record revealed a medication order for Levothyroxine 75 mcg, one tablet once daily at 7:00 AM before breakfast. 6. In an interview, E1 reported Levothyroxine had recently been changed from 75 mcg to 100 mcg. E1 acknowledged a verbal order was not documented in the resident's medical record.