The Nantucket Residence

An application fee adjusted by facility and capacity shall be charged by the department for the issuance of a license to operate a residential care facility for the elderly. After initial licensure, a fee shall be charged by the department annually on each anniversary of the effective date of the license. Annual Fee was not paid as of this date.

Basic Service Requirements. Every facility required to be licensed under this chapter shall provide at least the following basic services: (a) Care and supervision as defined in Section 1569.2. This requirement was not met as evidenced by: Based on record review and interview, R1 sustained a fall with injury due to lack of appropriate required supervision as stated in R1's plan of care. This posed an immediate health, safety and resident rights risk to residents in care.

Administrator Qualifications and Duties. (d) The administrator shall have the qualifications...(1) Knowledge of the requirements for providing care and supervision appropriate to the residents. This requirement was not met as evidenced by: Based on interview and record review, Administrator did not ensure a care and supervision level for R1 consistent with R1's written plan of care resulting in a fall with injury. This posed and immediate health and safety risk to residents in care.

Incidental Medical and Dental Care. (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health...This requirement was not met as evidenced by: Based on interview and record review, Licensee did not ensure an immediate call to 9-1-1 following the discovery of a R1's fall and pain on 7-8-23. This posed an immediate health and safety risk to residents in care.

Based on observation the licensee did not comply with the section cited above. LPA observed various toxins stored in unlocked shed in backyard 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. LPA observed window screen on side of facility detached and unsecured which poses/posed a potential 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 4 out of 4 staffing charts reviewed. Staffing charts did not contain evidence of regulatory required staff training which poses/posed a potential 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 4 out of 4 staffing charts reviewed. Licensee did not ensure completed medication training for staff who handle medication until 3/25/23 and licensee began operation on 5-3-22, which poses/posed a potential health, safety or personal rights risk to persons in care.

87506(a) Resident Records. (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident…This requirement was not met as evidenced by: Based on interview and record review, licensee did not ensure a complete and accurate record for R1 for multiple medications. This posed an immediate health and safety risk to residents in care.

87465(a)(4) Incidental medical and dental care. (a) A plan for incidental medical and dental care shall be developed by each facility…(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on interview and record review, licensee did not ensure R1 received appropriate assistance with self-administered medications as per Physician’s orders. This posed an immediate health and safety 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…This requirement was not met as evidenced by: Based on interview and record review, licensee did not ensure proper observation of R1’s skin condition which included scabies. This posed an immediate health, safety, and resident rights risk to residents in care.

87211(a)(1)(D). Reporting requirements. (a) Each licensee shall furnish to the licensing agency such reports…(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 as evidenced by: Based in interview and record review, licensee did not ensure the timely reporting of R1 contracting scabies. This posed a potential health and safety risk to residents in care.

87405(h)(5). Administrator Qualification and Duties. (h)The administrator shall have the responsibility to: (5) Provide or ensure the provision of services to the residents with appropriate regard for the residents' physical and mental well-being and needs…This requirement was not met as evidenced by: Based on interview, licensee did not ensure a service of safety for R1 in that a responsible person was allowed to handle and cut medication for R1 without appropriate staff intervention occurring. This posed an immediate health and safety risk to residents in care.

87463(a) Reappraisals. (a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate…This requirement was not met as evidenced by: Based on interview and record review, licensee did not ensure the appropriate and required updates to R1’s needs and service plan. This posed a potential health and safety risk to residents in care.

87468.1(a)(2). 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 interview and observation, licensee did not ensure a properly stored isolation cart outside of R1’s room during a scabies outbreak to promote safety. This posed an immediate health and safety risk to residents in care.

Based on interview the licensee did not comply with the section cited above in that S2 contracted COVID-19 on 7/22/22 and not reported by licensee to licensing agency. This posed a potential health, safety or personal rights risk to persons in care.

Based on observation, S1 was not wearing a mask while in the presence of resident in care. This poses an immediate health, safety or personal rights risk to persons in care.