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 04/20/2023.  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 fully implement an Acuity Based Staffing Tool (ABST). Findings include the following:

During an unannounced site visit on 04/20/2023 Compliance Specialist (CS) reviewed the facility ABST which was identified as the Resident Services Summary Report for Clinical Department and a Maximum Daily Staffing for Clinical Department report. CS also reviewed service plans for Resident #2-#4 (R2-R4) which revealed that the tools identified as being the facility ABST did not contain all the necessary 22 components.

In an interview with Staff #3 (S3) it was stated that the facility tool pulls from the resident care plans and their acuity and creates a staffing plan for them to staff accordingly.