Inspection Details: SMTH


Date
2/15/2023
Event ID
SMTH
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
2/15/2023
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 02/15/2023.  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




























































































C0361
Severity Level: 2
Visits: 1
Scope
Widespread/Minimal harm or potential for moderate harm
Visit Number
1
Visit Date
2/15/2023
Corrected Date
N/A
Details

Based on interview, observation, and record review it was confirmed the facility failed to fully implement and update an Acuity Based Staffing Tool (ABST). Findings include:


During an onsite interview on 02/15/2023, Staff #1 (S1) stated the following,

"There are residents who no longer live there who need to be archived and residents who have moved in and have not yet been added to the tool.

"Resident #4-5 (R4 and R5) moved into the facility a week or two ago.

"For swing shift the ABST, posted staffing plan, and schedule states there are 2 Caregivers (CG) and 1 Med Tech (MT) working.

"R4 moved in on 2/3/2023 and R5 moved in on 2/9/2023.


During an unannounced site visit on 02/15/2023, The Compliance Specialist (CS) observed 2CG and 1 MT on duty.  


A record review of the Posted Staffing Plan, Staff Schedule for February 2023, Resident #3 (R3) Service Plan, Progress Notes, the breakdown of their care on the facility's ABST, and the States internal ABST website. The States internal website shows resident #4-5 were not currently entered into the tool.


On 02/15/2023, these findings were reviewed and acknowledged by S1.