Print Inspection: DB6E

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 11/10/2022.  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 fully implement and update an Acuity Based Staffing Tool (ABST). Findings include:

During an interview on 11/10/2022, Staff #1 (S1) stated that the company ' s Acuity Based Staffing Tool (ABST) that they use does not have all 22 Activities of Daily Living (ADL ' s) as required by rule.

A review of the facility ' s posted staffing plan and the facilities ABST indicates the facility is missing multiple residents 22 ADLs with caregiving time needed for ADLs that has not been entered into the tool listed for those needs.

The above information was shared with and acknowledged by S1 on 11/10/2022.

Facility Plan of Correction: The facility is already working with their home office to change the tool to include all 22 ADLs for each resident.