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 03/13/2023. 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, observation and record review it was confirmed that the facility's internal courtyard had not been cleared of ice/snow in order to prevent falls. Findings include:
During an unannounced site visit on 03/13/23 Compliance Specialist (CS) observed the interior courtyard area. Snow had melted but sidewalks and walkways were wet with melted snow. No ice melt (salting rocks) were visible.
In an interview with Staff #1 (S1) on 03/13/23, they stated that they do not usually have any residents that use that courtyard in the winter time so maintenance does not remove snow or put out de-icer in the winter months. S1 is aware of a fall that occurred and has since put signs on the doors to the courtyard. S1 stated that EMT's were called and that the resident that fell was transported to the hospital. S1 stated that an internal investigation was conducted and that APS (Adult Protective Services) were notified.
On 03/13/23 CS confirmed internal investigation paperwork and APS notification paperwork.
In an interview with Resident #1 (R1) on 03/10/23 they stated that the courtyard is used regularly by staff and residents and they had a fall on 02/26/23 which resulted in a sprained and cut ankle that required stitches.
In separate interviews with Resident's #2-6 (R2-6) indicated that none of them use the courtyard to cut through the facility in the winter months and especially when there is snow and ice due to safety reasons. R3 stated that they only use the courtyard in the summer months.
Plan Of Correction: Facility has hung signs on the doors to the courtyard on both sides of the facility warning of hazards due to snow and ice.