FISHER FAMILY HOME, LLC

Based on documentation review, observation and interview, the manager failed to ensure a bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies was available in a bedroom. The deficient practice posed a risk if residents were unable to summon help from personnel members

Findings include:

1. A review of Department documentation revealed the facility was authorized to provide directed care services.

2. The Compliance Officer observed no bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies in one resident bedroom.

3. In an interview, E2 reported no bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies was available in the bedroom because R4 did not know how to use it and R1 had moved it out of the room.

4. In an interview, E2 acknowledged the resident bedroom had not included a bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies.

Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the facility were stored in a locked area and inaccessible to residents. The deficient practice posed a risk to the physical health and safety of residents with access to the materials.

Findings include:

1. During the environmental inspection of the facility, the Compliance Officer observed a bottle of "Xtra plus Oxi Clean" detergent sitting on a washer in the backyard of the facility. The area was accessible by residents.

2. In an interview, E2 acknowledged the aforementioned poisonous or toxic materials were not stored in a locked location and inaccessible to residents.

Based on record review and interview, the health care institution failed to develop and administer a training program for all staff regarding fall prevention and fall recovery.

Findings include:

1. A review of E1's and E3's personnel records revealed initial training and continued competency training in fall prevention and fall recovery was not available for review.

2. In an interview, E1 reported a fall prevention and recovery training program was developed and administered to some staff, but confirmed not all staff were trained at the time of the inspection.

Based on observation, documentation review, record review, and interview, the manager failed to ensure a caregiver's or assistant caregiver's skills and knowledge were verified and documented before the caregiver or assistant caregiver provided physical health services, for one of three sampled caregivers and assistant caregivers.

Findings include:

1. The Compliance Officer arrived at the facility at approximately 11:00 AM. At the time of arrival, the Compliance Officer observed E1 performing yard work in the front yard, and E2 and E3 were working inside the facility with the residents.

2. A review of facility documentation revealed a daily staffing schedule dated July 2023. The July 2023 schedule indicated the facility operated on two shifts: 7:00 AM to 7:00 PM, and 7:00 PM to 7:00 AM.

3. A review of the June 2023 daily staffing schedule revealed E1 was scheduled to work on July 3, 10, 17, and 24, 2023 from 7:00 AM to 7:00 PM.

4. A review of E1's personnel record revealed no documented verification of E1's skills and knowledge.

5. In an interview, E1 reported E1 thought a skills and knowledge verification document was in each personnel file, and stated E1 would "get it corrected."

Based on observation, documentation review, and interview, the manager failed to ensure documentation was maintained of the caregivers and assistant caregivers who worked each day, including the hours worked by each.

Findings include:

1. The Compliance Officer arrived at the facility at approximately 11:00 AM. At the time of arrival, the Compliance Officer observed E1 performing yard work in the front yard, and E2 and E3 were working inside the facility with the residents.

2. A review of facility documentation revealed a daily staffing schedule for July 2023. The July 2023 schedule indicated E1 was scheduled to work on July 3, 10, 17, and 24, 2023 from 7:00 AM to 7:00 PM. The July 2023 schedule did not indicate E3 was scheduled to work on July 25, 2023, the day of the inspection. E3 was not included on the July 2023 work schedule.

3. In an interview, E1 stated E3 was a new employee and E1 had not revised the work schedule. E1 acknowledged the manager failed to ensure accurate documentation of the caregivers and assistant caregivers who worked each day, including the hours worked by each, was not maintained.

Based on documentation review, observation, and interview, the manager of a facility authorized to provide directed care services failed to ensure a means of exiting the facility, allowing the resident to be at least 30 feet away from the facility, was controlled or alerted employees of the egress of a resident from the facility.

Findings include:

1. A review of Department documentation revealed the facility was authorized to provide directed care services.

2. During the environmental inspection of the facility, the Compliance Officer observed three doors exiting the facility allowing the resident to be at least 30 feet away from the facility. Alarms were installed on the doors, however, none of the alarms observed controlled or alerted employees of the egress of a resident from the facility.

3. In an interview, E1 acknowledged the doors exiting the facility did not control or alert employees of the egress of a resident from the facility at the time of the inspection. E1 immediately changed the batteries in the door alarms and turned the units on to alert staff of any resident egress.

Based on observation and interview, the manager failed to ensure equipment used at the assisted living facility was free from a condition or situation that may cause a resident or other individual to suffer physical injury.

Findings include:

1. During the environmental inspection of the facility, the Compliance Officer observed the flooring in the dining room was lifting off of the floor in two different locations, presenting a tripping hazard.

2. In an interview, E1 acknowledged the flooring lifting away from the floor and reported E1 previously contacted the home owner to get the flooring fixed. E1 contacted the home owner again while The Compliance Officer was onsite.