Inspection Details: 12MZ

Records Request Print
Date
8/1/2022
Event ID
12MZ
Inspection type(s)
Complaint Investig.
Deficiencies cited
2

Citation Details

C0010
Severity Level: 2
Visits: 1
Scope
Isolated/Minimal harm or potential for moderate harm
Visit Number
1
Visit Date
8/1/2022
Corrected Date
N/A
Details

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 08/01/2022.  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








































































































C0360
Severity Level: 2
Visits: 1
Scope
Isolated/Minimal harm or potential for moderate harm
Visit Number
1
Visit Date
8/1/2022
Corrected Date
N/A
Details

Based on interview and record review, it has been confirmed that the facility failed to have sufficient staff to meet the scheduled and unscheduled needs of residents. Findings include:

During an unannounced site visit on 08/01/2022; the Compliance Specialist (CS) interviewed Staff #1, Staff #2, Staff #4 and Resident #1-Resident #3, separately. It was stated that in July staffing was a concern. It was stated that there were multiple call outs due to staff illness, which resulted in short staffing and missed needs.

CS reviewed Service plans for Resident #1-Resident #3, Staff Schedules for July and August 2022, Acuity Based Staffing Tool and call light logs from 07/05/2022-07/08/2022; which revealed multiple dates where the facility was not staffed to their posted staffing plan. CS revealed 42 instances from 07/05/2022-07/08/2022 where call light response times exceeded 15 minutes, with multiple instances with 30 plus minute wait times.

The above information was shared with Staff #1 on 08/01/2022 who was in agreement.