Print Inspection: GL1P

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 7/7/2022.  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 observation, interview and record review it was confirmed that the facility failed to fully implement and update an Acuity Based Staffing Tool (ABST). Findings include but not limited to:

During an unannounced site visit on 7/7/2022, Compliance Specialist (CS) observed four caregivers (CGs) and two Medication Technicians (MTs) working the floor upon CS arrival to the facility. A fifth CG arrived to work from 10am-1pm.

During an interview, Staff #1 stated:

*Facility is using the department ABST.

*The facility has decided it currently needs five CGs and two MTs during the

day.

*The facility is not sure how to determine how many staff they need during

each shift to meet their current care needs hours.

A review of the Facility's ABST indicates that they facility has 75.56 hours of care to be provided on Thursday day shifts. A review of the facility's schedule for 7/7/2022 indicates they only had 48 hours of direct care staff scheduled.

These findings were reviewed with and acknowledged by S1 on 7/7/2022.

Facility POC: Executive Director and Staffing Coordinator to review ABST and arrange schedule so that their needed care hours are met. If support staff are providing care, facility staff will implement system to document that time.