Rialto Assisted Living

Based on record review, the licensee did not comply with the section cited above in 2 out of 7 residents by not ensuing the facility maintained a current Needs and Service Plan for each resident in care which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview and record review, the Administrator did not comply with the section cited above in 2 out of 7 residents by not maintaining an accurate MARs log free of errors and missing a Med-Tech initial stating a medication had been dispensed and or a prescribed medication was not listed on the residents MARs which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 7 residents. LPA observed 2 residents were missing a current Physician Report which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 7 staff files by not ensuring each staff maintained a Health Screening Report in their Personnel file, LPA did observed a TB test results which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above by not ensuring the resident shower was not maintained as a storage for a wheelchair, covered toilet commode, and other assisted devices which poses a potential health, safety or personal rights risk to persons in care.

87463(C)Behavioral expression, as defined in..that may result in harm to self or others,..unsafe wandering, elopement,..lacking in hazard awareness, or lacking in impulse control. Based on observation, record review, and interviews, the licensee did not comply with the section cited above by not ensuring resident did not leave the facility unassisted.

Based on observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 5 residents in care by not ensuring the MARS contains current and accurate information regarding residents medication. One resident MARS was missing two medications that was prescribed by the physician which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, interview, and record review, the licensee did not comply with the section cited above for 4 out of 8 residents in care by ensuring that the facility attained and or completed the required step to aquire a hospice waiver increase from 4 to 8 resident receiving hospice care which poses an immediate health, safety or personal rights risk to persons in care.

Based on record reviews the licensee did not comply with the section cited above by not ensuring each resident had an updated Physician's Report (LIC602) completed and included in each resident file for two, (2) residents which poses a potential health, safety or personal rights risk to persons in care.

Based on record reviews, the licensee did not comply with the section cited above by not ensuring a member of the staff had all required documented training; which poses a potential health, safety or personal rights risk to persons in care.

Maintenance and Operation: (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on interviews and observations, the Licensee failed to ensure that at least 1 out of 48 rooms were kept clean and sanitary at all times. This is poses an immediate health risk to residents.

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: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met based on interviews conducted. The licensee did not comply with the section cited above allowing a staff to voice unwarranted opinions on a resident manor during a resident council meeting.

1569.157. Resident-oriented facility council. (a) Every licensed residential care facility for the elderly, at the request of two or more residents, shall assist the residents in establishing and maintaining a single resident council at the facility. The resident council shall be composed of residents of the facility. Family members, resident representatives, advocates, long-term care ombudsman program representatives, facility staff, or others may participate in resident council meetings and activities at the invitation of the resident council. This requirement was not met based on interviews conducted. The licensee did not comply with the section cited above allowing a staff member to be present in resident council meeting without an invitation to the meeting.

General Food Service: All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.The facility is not meeting this requirement as evidenced by: Information was received through interviews that the facility kitchen has cockroaches, that bedrooms have ants and earwigs.

Additional Personal Rights of Residents in...Facilities : (a) In addition to the rights listed...residents... shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs... This requirement was not met as evidenced by: Based on record review and interviews, the Licensee did not comply with the above regulation with one resident (R2). LPA Colvin learned that R2 had a change in condition, and their facility Care Plan was not updated. Staff additionally failed to immediately provide R2 with life saving measures. This was an immediate health risk for R2.

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: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on record review and interviews, the Licensee did not comply with the above regulation with at least one resident. LPA Colvin learned that R1 has hit residents & staff with their electric scooter on multiple occasions. There is no record of facility intervention. This is an immediate safety risk.

Additional Personal Rights of Residents in... Facilities : (a) In addition to the rights listed...residents...shall have all of the following personal rights: (27) To keep, have access to, and use their own personal possessions...and to keep and be allowed to spend their own money... This requirement was not met by: Based on interviews and record review, the Licensee did not comply with the above regulation with at least 4 residents. LPA Colvin observed 4 residents did not have access to their April 2020 P&I until 4/9/20, six days after the Licensee received the checks. This was a potential personal rights violation.

Personal Accommodations and Services: (d) The following space and safety provisions shall apply to all facilities: (2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. This requirement was not met by: Based on interviews and record review, the Licensee did not comply with the above regulation with at least one area of the facility. LPA Colvin confirmed that Room #32 was in a state of disrepair for over 3 weeks, leaving the occupant displaced. This was a potential personal rights violation of the occupant.

Personal Accommodations and Services: (a) Living accommodations...shall be related to the facility's function...The following provisions shall apply: (3)...the licensee shall assure provision of: (C)...bath towels, hand towels and wash cloths. The quantity shall be sufficient... This requirement was not met by: Based on interviews and internal audit, the Licensee did not comply with the above regulation with at least one category of item. LPA Colvin confirmed that the facility did not have a sufficient supply of towels, as there was only one spare clean towel. This was a potential health risk to all residents in care.

Observation of the Resident:...shall ensure that residents are regularly observed for changes...and that appropriate assistance is provided...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 regulation was not met by: Based on interviews and record review, the Licensee did not comply with the following regulation in that Administrator observed resident to have a significant change in condition and did not re-evaluate for level of care, resulting in infected wound. This was an immediate risk to R1.

Maintenance and Operation: (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met by: The Licensee did not comply with the above regulation with at least one area of the facility. LPA Colvin observed that paper towels in the common bathroom are stored on the counter, and not in the dispenser which is on the wall. This is a potential health risk to all persons.

Maintenance and Operation: (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on interviews and observations, the Licensee did not comply with the above regulation with one resident room (#35). LPA Colvin observed a bed bug on the ceiling above R1's bed in Room #35. Facility has only sprayed the perimeter of the room. This is a potential health and personal rights violation.

Maintenance and Operation: (g) Facilities which have machines and do their own laundry shall: (1) Have adequate supplies available and equipment maintained in good repair.... This requirement was not met by: Based on interviews and record review, the Licensee did not comply with the above regulation with 1 of 2 washing machines. LPA Colvin observed that 1 of the 2 facility washing machines has been out of order since 6/16/21 and will not be fixed until at least 7/8/21. This is a potential personal rights and health risk.