Inspection Details: MCLM


Date
7/14/2023
Event ID
MCLM
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
7/14/2023
Corrected Date
N/A
Details

The findings of the on-site investigation, conducted 06/01/23 are documented in this report. The investigation was conducted to determine compliance with the OARs 411 Division 54 for Residential Care and Assisted Living Facilities.



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




C0361
Severity Level: 2
Visits: 1
Scope
Widespread/Minimal harm or potential for moderate harm
Visit Number
1
Visit Date
7/14/2023
Corrected Date
N/A
Details


Based on observation, interview, and record review, conducted during a site visit on 07/14/23, it was confirmed the facility failed to fully implement an Acuity Based Staffing Tool. Findings include, but are not limited to:  


Onsite facility observation on 07/14/23 at 10:45 am, revealed 2 caregivers and 1 med-tech were working memory care which matched the posted staffing plan.


In an interview on 07/14/23 at 11:00 am, Staff 1 (Administrator) stated the facility had been using ODHS ABST staffing tool but was not familiar with entering the residents, ADL's, creating a staffing plan, or scheduling around the hours provided using the information in the ABST tool.   


A review of the facility's ABST on 07/14/23 revealed the tool had been set up but was not correct. All residents were entered but the hours were entered in error for the ADL's and did not match the posted staffing plan. Staffing hours were listed at 383.77 which would mean the facility would need 51 care staff for day shift for 24 residents.


The above information was shared with Staff 1 (Administrator) and Staff 2 (ED) on 07/14/23. They acknowledged the findings.


It was confirmed the facility had failed fully implement an Acuity Based Staffing Tool.  


Verbal Plan of Correction: Sending facility ABST Guidebook, and they will get ABST updated.