Tiffany's Board & Care

(a)(8) …residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:.. (8) To be free from neglect,…This requirement was not met as evidenced by: Based on record review & staff interviews, the licensee did not comply with the section cited above and provide care by medical professional to resident#1 who had stage 4 pressure injuries, sepsis and E-Coli which poses an immediate health, safety or personal rights risk to persons in care.

(b)(1)…licensee shall be responsible for...(1) monitoring of the resident's ongoing ability to operate the equipment in accordance with the physician's orders.This requirement was not met as evidenced by: Resident#1 did not have a physician order for oxygen administration on file.Based on file review, Administrator did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.

(a)(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.This requirement was not met by evidence of: Based on interviews and record reviews, Administrator failed to seek timely medical attention for resident#1 when resident sustained stage 4 pressure injuries, which poses an immediate health, safety or personal rights risk to persons in care.

(a) Persons who require health services for...shall not be admitted or retained in a residential care facility for the elderly:(1) Stage 3 and 4 pressure injuries.This requirement was not met as evidenced by: Based on record review & staff interviews, the licensee retained a resident with a prohibited health condition (Stage 4 pressure injury) who was not on hospice, which poses an immediate health, safety or personal rights risk to persons in care.

Healing Wounds (a)(3)(B) All aspects of care performed by the medical professional and facility staff shall be documented in the resident's file.This requirement was not met as evidenced by: Based on record review & staff interviews, the licensee did not: (1) comply with the section cited above; (2)document or update resident#1's Plan of Care; (3) provide care by medical professional to resident#1 who had stage 4 pressure injuries, sepsis and E-Coli which poses an immediate health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care (a)(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.This requirement was not met by evidence of: Based on interviews and record reviews, Administrator failed to seek timely medical attention for resident#1 when resident sustained stage 4 pressure injuries, which poses an immediate health, safety or personal rights risk to persons in care.

Medical Assessment(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment.This requirement was not met as evidenced by: During the subsequent visit by LPA Pena on 10/19/2022, LPA observed that the facility did not have R1’ s current physician report on file which poses a potential Health, Safety or Personal Rights risk to the residents in care.

Reappraisals ..(a) The pre-admission appraisal shall be updated, in writing... to note significant changes and to keep the appraisal accurate... shall document changes in the resident's physical, medical...condition. Significant changes shall include.. (3) Any illness, injury,,,or change in the health care needs of the resident that results in a circumstance or condition specified in Sections 87455(c) or 87615, Prohibited Health Conditions. (b) The licensee shall immediately bring any such changes to the attention of the resident's physician and his family or responsible person.This requirement was not met as evidenced by: During the subsequent visit by LPA Pena on 10/19/2022, LPA observed that R1 did not have a reappraisal to note significant changes and update her declining mental/ health issues since mid-June 2022, which poses a potential Health, Safety or Personal Rights risk to the residents in care.

87465 Incidental Medical and Dental Care..(g) The licensee shall immediately telephone 9-1-1 if an injury..imminent threat to a resident’s health..an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4).This requirement was not met as evidenced by: Based on the interview conducted, Licensee noticed R1’s change of health condition in mid-June 2022 and on 07/20/23, licensee suspected that R1 had a mini stroke or TIA. However, Licensee didn’t call 911 until 08/05/23 when R1’s pressure injury opened.

Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. .. use the form LIC 602 (Rev. 9/89), Physician's Report..This requirement was not met as evidenced by: Resident#1 did not have a current physician report on file.Based on file review, Administrator did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.

Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. .. use the form LIC 602 (Rev. 9/89), Physician's Report..This requirement was not met as evidenced by: Resident#1 did not have a current physician report on file.Based on file review, Administrator did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.