Assisted Living and Residential Care Facilities must operate and provide services in compliance with all applicable State and local laws, regulations and codes.  This report reflects the findings of the complaint investigation conducted 08/22/2022.  The facility was evaluated for compliance with Oregon Administrative Rule 411, Division 54 and if applicable, Oregon Administrative Rule 411, Division 57.  The following deficiencies were identified:

Abbreviations possibly used in this document:

ADL:activities of daily living

bid:twice a day

CBG:capillary blood glucose or

blood sugar

cc:cubic centimeter

CG:caregiver

cm:centimeter

F:Fahrenheit

HH:Home Health

HS or hs:hour of sleep

LPN:Licensed Practical Nurse

MA:Medication Aide

MAR:Medication Administration

Record

MCCMemory Care Community

mg:milligram

ml:milliliter

O2 sats:oxygen saturation in the

blood

OT:Occupational Therapist

PT: Physical Therapist

PRN:as needed

qd:every day or daily

qid:four times a day

RN:Registered Nurse

SP:service plan

TAR:Treatment Administration

Record

tid:three times a day

Based on interview and record review it was confirmed that the facility failed to give residents informed choice and opportunity to select or refuse service and to accept the responsibility or consequences. Findings include:

Compliance Specialist (CS) reviewed Resident ' s Bill of Rights, Resident #1s Oregon Portable Orders for Life-Sustaining Treatment (POLST). The POLST states Do Not Attempt Resuscitation/DNR and is signed by the resident, doctor, and POA.

In interviews with Staff #1-2 on 08/02/22, they stated that residents have the right to refuse services at any time and this includes having a DNR. Emergency Services had to perform CPR on Resident #1 on 07/16/22 due to the facility staff not having access to the POLST.

The above information was discussed with Staff #1-2 who acknowledged that the incident did occur.

Based on interview and record review, it was confirmed that the facility failed to provide health services and have systems in place to respond to the 24-hour care needs of residents, including having written policies and procedures on medical emergency response for all shifts. Findings include:

Review of Resident #1s progress notes for July 2022, POLST, and staff schedule for July 16th, 2022. CS requested the facility 's policy and procedures for medical emergency response for all shifts and the facility was unable to provide documentation. During onsite visit on 08/02/22, the facility did not have any written policy and procedures readily available for staff to access.

Interviews on 08/02/22, Staff #1-2 stated they were unaware of any written policy and procedures for medical emergency response. They advise staff to notify the administrator, the nurse, and the house manager if there is an emergency for further direction. The POLST are kept in the office, which is locked after 5pm. Staff are unable to access medical records and access to the printer during this time. If they need to print off any current MARS for Emergency Medical Services, they would not be able to do this.