The Harvest at Fowler

Based on review of records, the licensee did not comply with the section cited above in that 1 of 4 records reviewed disclosed medication is not being provided as prescribed. R1's MARS shows medication (Ondansetron HCL 4 mg tablet, generic for Zofran 4 mg tab with instructions take 1 tablet by mouth every 6 hrs as needed for nausea/vomitting) should have a count of 27 but has 26. Medication is short 1 tablet. This poses an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in that 2 of 3 files reviewed did not have pre-admission appraisal. Reappraisals are not being completed. Reappraisals observed to have not been completed in 2 of 3 files reviewed. (3rd file reivewed was a new resident). This poses a which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA observation, the licensee did not comply with the section cited above in that 2 of 6 bedrooms observed with chemicals accessible to residents in care. Gardening tools observed unlocked and accessible to residents in care. This poses a potential health, safety or personal rights risk to persons in care.

Based on LPA interview with Administrator, the licensee did not comply with the section cited above in that R1 was admitted on hospice 5/18/24. A hospice care plan/training was not secured by the facility at time of admittance. This poses a potential health, safety or personal rights risk to persons in care.

Based on LPA observations, the licensee did not comply with the section cited above in that various resident bathrooms and activity cabinet was observed with chemical/items that could pose a danger to residents in care unlocked and accessible. This poses a potential health, safety or personal rights risk to persons in care.

Based on LPA observations, the licensee did not comply with the section cited above in that room #305 was observed with an oxygen tank inside without "oxygen in use signs posted as required. This poses a potential health, safety or personal rights risk to persons in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement was not met as evidence by: LPA observation of Incident report. On 3/9/23 R1, jumped fence and AWOL'd from the facility resulting in an injury requiring medical attention.602 dated 2/17/23 stated that R1 was "not able to leave the facility unassisted". This posed an immediate health, safety and or personal rights risk to resident in care. Civil penalty assessed.

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement was not met as evidenced by Based on medical records review, R1 was admitted for cellulitis/sepsis, which poses an immediate Health, Safety or personal rights risk to the clients in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (5) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by Based on review of records and interviews R1 did not recieve the correct dose of medication which poses an immediate Health, Safety or personal rights risk to the clients in care.