Print Inspection: 0UOM

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 08/25/2022.  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 appropriately respond to incidents. Findings include the following:

During an unannounced visit on 08/25/2022 Compliance Specialist (CS) reviewed facilities Resident Occurrence Reports and Resident Occurrence Investigation Worksheets for August 2022. CS requested follow-up verification of physician notification and family notification for an incident with Resident #2 (R2). Facility failed to provide proof of notification.

In an interview with Witness #1 (W1) it was stated that the residents doctor and family were not notified of incident even though facility stated they notified listed parties.