Little Brook Care Home

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility (...) by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on medication count and records reviewed, the facility did not ensure that resident (R1) was receiving medications as prescribed, which poses an immediate health, safety, and personal rights risk to residents in care.

Incidental Medical and Dental Care- (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication. This requirement was not met based on records and interviews that found R1 did not have written orders, licensee did not confirm orders and licensee did not promptly administer medications when received.This posed an immediate risk to R1.

Medical Assessment (b) The medical assessment shall include, but not be limited to: (2) Documentation of prior medical services and history and current medical status… This requirement was not met by a review of records finding R1 had medical condition not identified in the LIC 602. This posed a potential risk to R1. This requirement was not met based on record review that found R1’s LIC 602 to was not current to medical conditions at admission.

Incidental Medical and Dental Care (h)The following requirements shall apply to medications. which are centrally stored:(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.This requirement was not met based on observations on 2 occasions where medications were left unsecured,for a short time, in an accessible area to residents. This posed a potential risk to residents

Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as …: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence … (D) Any incident which threatens the welfare, safety or health of any resident, … This requirement was not met in two incidents for R1 that were not reported to CCLD. This posed a potential risk.

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (16) To receive or reject medical care or other services.This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the facility interfered with R1’s right to receive dialysis treatment on their scheduled appointment date, which poses an immediate health, safety, and personal rights risk to residents in care.

1569.683 Eviction notices; reasons for eviction contents; service (a) In addition to complying with other applicable regulations, a licensee of a residential care facility for the elderly who sends a notice of eviction to a resident shall set forth in the notice to quit the reasons relied upon for the eviction, with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. In addition, the notice to quit shall include all of the following: (2) Resources available to assist in identifying alternative housing and care options, including public and private referral services and case management organizations. (3) Information about the resident's right to file a complaint with the department regarding the eviction, with the name, address, and telephone number of the nearest office of community care licensing and the State Ombudsman. This requirement is not met as evidenced by:Based on interviews conducted and records reviewed, the facility did not include required information in R1’s eviction notice prior to serving notice, including housing resources and the resident’s rights to file a complaint with contact information of the nearest community care licensing office and the State Ombudsman, which poses a potential health, safety, and personal rights risk to residents in care.

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 is not met as evidenced by: Based on records reviewed and interviews conducted, the facility observed changes in R1’s condition and did not document such changes or bring changes to the attention of R1’s physician or responsible party, which poses an immediate health, safety, and personal rights risk to residents in care.

87224 Eviction Procedures (f) A written report of any eviction shall be sent to the licensing agency within five (5) days.This requirement if not met as evidenced by: Based on interviews conducted and records reviewed, the facility did not provide the Department with a written report of R1’s eviction within five (5) days, which poses a potential health, safety, and personal rights risk to residents 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: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.This requirement is not met as evidenced by: Based on records reviewed and interviews conducted, the facility observed R1’s change in condition and did not seek medical attention timely, which poses an immediate health, safety, and personal rights risk to residents in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical(…)shall be developed by each facility. The plan shall encourage routine medical(…)care and provide for assistance in obtaining such care, by compliance with the following: (2) The licensee shall provide assistance in meeting necessary medical(…)needs. This includes transportation which may be limited to the nearest available medical(…)facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service.This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the facility did not ensure R1 received transportation services to their dialysis appointment, which poses an immediate health, safety, and personal rights risk to residents in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility (...) by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on medication count and records reviewed, the facility did not ensure that residents (R1, R2, & R3) were receiving medications as prescribed, which poses an immediate health, safety, and personal rights risk to residents in care.