Print Inspection: HV9X

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 9/20/2022.  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 the facility failed to fully implement and update an Acuity Based Staffing Tool (ABST). Findings include but are not limited to:

In an interview on 09/20/2022 Staff #1 (S1) stated that their first day was on 09/06/2022. S1 stated they have not been trained on ABST. Staff 5 (S5) stated that ABST training was scheduled and the ABST was being used.

On 09/20/2022, S1 provided a spreadsheet titled "Service Plans by Provider" by the Eldermark program. A review of the facility record omitted the following Activities of Daily Living (ADLs) for Resident #1 (R1):

*Personal hygiene

*Grooming

*Bowel and bladder management

*Transferring

*Repositioning

*Ambulation

*Medication administration

*Providing non-drug interventions for pain management

*Providing treatments

*Providing non-drug interventions for behaviors

*Assisting with leisure activities

*Monitoring physical conditions and symptoms

*Monitoring behavioral conditions and symptoms

*Assisting with communication

*Responding to call lights

*Resident specific housekeeping or laundry services

*Additional care such as smoking or pet assistance.

A review R1's evaluation dated 07/07/2022 shows zero minutes allocated to the task of housekeeping. A review of R1's service plan indicated they require assistance of staff to receive a deep clean of the apartment once weekly. The activity of daily living of Housekeeping has not been captured in the ABST for R1.

S5 emailed an ABST Calculation Tool with 1,544.93 hours worked for day shift, 1,347.8 hours worked for swing shift and 225.24 hours were worked for NOC Shift between 08/09/2022 and 09/19/2022.

In an interview on 09/20/2022, S1 and S5 were not able to demonstrate how the total ABST informs the staffing plan.

On 09/23/2022, via telephone, these findings were reviewed with S1. No further information was provided.

Plan of correction: The Executive Director stated that they would include all the aspects of demonstrating a fully implemented ABST within 7 days.