PAYSON, AZ- RIM COUNTRY HEALTH & RETIREMENT COMMUNITY

The Department of Health & Human Services conducted an inspection of the facility. The following highlighted decencies listed below were found in a public survey.

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Based on clinical record review, facility documentation, staff interviews, and policies and procedures, the facility failed to ensure two residents (#220, #221) were not neglected resulting in injury of unknown origin. The deficient practice could result in residents suffering from preventable injuries due to neglect.

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Based on staff interviews, review of facility documentation, policy and procedures, the facility failed to implement their policy on abuse reporting and investigation for four residents (#15, #218, #220, and #221). The deficient practice could result in abuse continuing and not being prevented.

Respond appropriately to all alleged violations.

Based on review of the clinical record, facility documentation, review of the State Agency database, staff interviews and review of policy and procedure facility failed to ensure two allegations of abuse and two injuries of unknown origin were fully investigated. The deficient practice could result in allegations of abuse and injuries of unknown origin not being investigated and abuse/neglect occurring in the facility.

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Based on clinical record review, staff interviews and facility policy and procedures, the facility failed to revise and update care plans to include non-pharmacological interventions for psychotropic medications for three residents (#52, #5, #24). The deficient practice could result in resident needs not being met.

Ensure services provided by the nursing facility meet professional standards of quality.

Based on observation, staff interviews, and review of policy, the facility failed to ensure that professional standards of practice were followed during medication administration when staff left medications at the bedside unattended and did not assure that the resident (#10) took an inhaled medication according to physician’s orders, that medications are not left unattended on the medication cart, and a medication was left unlocked and unattended. The deficient practice could result in residents not receiving the prescribed dose of medication and resident’s having access to unprescribed medications.

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Based on staff interviews and facility documentation, the facility failed to use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week.

Ensure medication error rates are not 5 percent or greater

Based on observations, staff interviews, review of records, and policy review, the facility failed to ensure the medication error rate was not 5% or greater, by failing to administer medications as ordered for one resident (#31). The medication error rate was 10%. The deficient practice could result in further medication errors.