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 10/18/2022.  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 have an Acuity Based Staffing Tool that accurately reflected the resident population and their needs. Findings include the following:

During an unannounced site visit on 10/18/2022 Compliance Specialist (CS) reviewed the facilities Acuity Based Staffing Tool (ABST) against the facilities resident roster it was discovered that some of the residents listed on the ABST did not have any time included on their ABST for any need. CS reviewed the most recent service plan for Resident #2 (R2) and Resident # 3(R3) against the facility ABST for R2 and R3 and inconsistencies were identified between R2s' and R3s' service plans and their ABST questions. Service plan indicated that R2 and R3 have the need for assistance with personal hygiene and grooming but the ABST indicates that no time is used for these activities.

In an interview with Staff #1 (S1) on 10/18/2022 who stated that the facility has not updated the ABST in over a month and some of the residents that have moved in since then have not been added to the ABST.