Belmont Village Albany

Based on observation, interview and record review, the licensee did not comply with the section cited above by not properly storing required locked items for R1 and R2 which poses an immediate health and safety risk to persons in care.

87705 Care of Persons with Dementia(c) Licensees... with dementia shall be responsible ...(5) Each resident with dementia shall have an annual medical assessment ... annually, ... a reassessment of the resident’s dementia care needs.-This requirement was not met as evidenced by: Based on interviews and records reviewed the Licensee did not comply with the section cited above by not abiding by R1's admission agreement which posed a potential health and safety risk to residents in care.

87507 Admission Agreements(f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments.-This requirement was not met as evidenced by: Based on interviews and records reviewed the Licensee did not comply with the section cited above by not abiding by R1's admission agreement which posed a potential health and safety risk to residents in care.

87632 Hospice Care Waiver (d) If the Department grants a hospice care waiver it shall stipulate terms and conditions of the waiver as necessary to ensure the well-being of terminally ill residents and of all other facility residents...(2) The licensee shall notify the Department in writing within five working days of the initiation of hospice care services...or within five working days of admitting a resident already receiving hospice care services. The notice ...include...name...date of admission... name and address of the hospice.-This requirement was not met as evidenced by: Based on interviews and records reviewed the Licensee did not comply with the section cited above by not providing R1's Initiation of Hospice notification and LIC602 to CCLD which posed a potential health and safety risk to residents in care.

87633 Hospice Care of Terminally Ill Residents (g) In addition to...Section 87211, Reporting Requirements... report...hospice services are interrupted or discontinued for any reason...any deviation from the resident’s hospice care plan, or other incident...- This requirement was not met as evidenced by:

87224 Eviction Procedures (i)…a ... resident receiving hospice services ... resident's condition has changed ... joint determination has been made by the Department, the resident or resident's health care surrogate decision maker, the resident's hospice agency, a physician...- This requirement was not met as evidenced by: Based on interviews and records reviewed, Licensee failed to ensure the facility sought joint determination before denying R1’s return to the facility after being released for treatment of emergency services which posed an immediate health and safety risk to residents in care.

Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports…(2) Occurrences…epidemic outbreaks…major accidents which threaten the welfare, safety or health of residents, personnel or visitors…within 24 hours either by telephone or facsimile… - This requirement is not met as evidence by:Based on investigation, licensee did not comply with the section cited above by notifying CCLD of the incident within 24 hours which poses a potential health and safety risk to the persons in care.

87705 (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s... safety and health care needs as identified in his/her current appraisal. This requirement was not met as evidence by: Based on LPAs interviews and record review the Licensee did not comply with the section cited above in supporting R1's needs, which poses a potential health and safety risk to residents in care.

87405(d)(2) ADMINISTRATOR - QUALIFICATIONS AND DUTIES(d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7)...(2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement is not met as evidenced by: Based on observation on 7/22/22, Licensee did not comply with the regulation cited above by not physically distancing residents in accordance to PIN 21-49-ASC and local public health guidance. AGPA and LPA observed 5 residents on wheel chairs in one round dining table in memory care which poses a potential health and safety risk to persons in care.

Reporting Requirements. A written report shall be submitted to the licensing agency...within seven days of the occurrence of any of the events specified... This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above by not submitting incident report to CCLD which poses a potential health and safety risk to the persons in care.

CARE OF PERSONS WITH DEMENTIA(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following:(5)Each resident with dementia shall have an annual medical assessment as specified...least annually..This requirement was not met as evidenced by: Based on record review, Licensee did not comply with regulation cited above. On 01/19/2023 LPA observed R3's medical assessment was last completed on 04/2021 which poses a potential health and safety risk to persons in care.

Incidental Medical and Dental CareThe licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including...This requirement is not met as evidenced by: Based on record review and interviews, Licensee did not comply with the regulation above, facility failed to take R1 medical facility or to call 9-1-1 in timely manner after sustaining skin tear, which poses an immediate health and safety risk to residents in care.

Personal Rights of Residents in All Facilitiesa) Residents in all residential care facilities for the elderly shall have all of the following personal rights: 2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above resulting R1 sustaining skin tear due to improper handling during transfer which poses an immediate health and safety risk to the residents in care.

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional.....This requirement is not met as evidenced by: Based on interview and records review, the licensee did not comply with the section cited above by not properly observing resident's changes in condition.

Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions.This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above by not following doctor's orders which poses a potential health and safety risk to the residents in care.

Personal Rights of Residents in All Facilities. To wear their own clothes; to keep and use their own personal possessions...This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above resulting in R1’s device removed from the room which poses a potential health and safety risk to the residents in care.

Personal Rights of Residents in All Facilities. To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above resulting in R1 sustaining severe bruising due to improper handling during transfer which poses an immediate health and safety risk to the residents in care.