Appleton Homes

To have their visitors...permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement is not met as evidenced by Based on interviews and record review, the licensee did not comply with the section cited above as staff prevented R1 from having a visitors which poses as a potential health, safety or personal rights risk to persons in care.

If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability.This requirement is not met as evidenced by Based on interviews and record review, the licensee did not comply with the section cited above the as the licensee's corporationwas in a suspended status which poses as a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in 1 resident's bed placement did not allow access to the exit and did not provide ample space for a passageway which poses an immediate health, safety or personal rights risk to persons in care.

Based on interview, the licensee did not comply with the section cited above in residents who do not reside in Bedroom #5 utilized the private restroom in Bedroom #5 which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in the emergency side exit passageway was obstructed which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, interview, record review, the licensee did not comply with the section cited above in 5 residents medications were not properly documented which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, record review, the licensee did not comply with the section cited above in residents did not have a PRN Authorization letter which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in medications were accessible in a file cabinet which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 residents did not have completed documents which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in non-perishable food cans were expired which poses/posed a potential health, safety or personal rights risk to persons in care.

(a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (2) Gastrostomy tubes.This requirement was not met as evidenced by: Based on interview and record review, the licensee did not comply with the above cited section as the licensee retained a resident with a prohibted health condition who was not on hospice during the time of admission which poses/posed an immediate health, safety, and personal rights risk to residents in care.

Based on observation and interview, the licensee did not comply with the section cited above in the staff room was not secured which poses/posed a potential health, safety or personal rights risk to persons in care.

(a) The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so …This requirement was not met as evidence by: Based on interview and record review, the licensee did not comply with the section cited above as the licensee did not issue the resident’s representative a refund which poses/posed an immediate health, safety, and personal rights risk to residents in care.

(f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments.This requirement was not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above as the licensee did not obtain required documents and did not conduct a pre-placement appraisal which poses/posed an immediate health, safety, and personal rights risk to residents in care.

§1569.312 Basic services requirementsEvery facility required to be licensed under this chapter shall provide at least the following basic services:(a) Care and supervision...This requirement is not met as evidenced by: Based on interview and file review the licensee did not comply with the section cited above as R1 suffered a fall at the facility and no safety measures were in place to minimize the risk of falls during the timeframe R1 fell which poses a potential health and safety risk to clients in care.

87309 Storage Space and Access(a)... the licensee shall ensure that ... knives...tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended...This requirement is not met as evidenced by: Based on observation and interview the licensee did not comply with the section cited above as multiple tools were left unattended on the facility's back patio which poses an immediate safety risk to clients in care.

(3) Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirment wa not met as evidence by: Based on interviews and records review the licensee did not comply with regulation cited as R3 was suspended in their hoyer lift for an extended period of time due to staff failing to demonstrate knowledge for use of hoyer lift, which posed a potential health and safety risk to residents in care.

Based on record review and interview, the licensee did not comply with the section cited above as staff training does not have times, dates, and hours of training provided as Administrator stated they only sign off on all the training on one (1) day, which poses a potential health, safety or personal rights risk to persons in care.

Based on record review and inetrview, the licensee did not comply with the section cited above as not all medication being received by the facility is being proprely documented on the CSMDR, which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above: Both bathrooms and kitchen observed in disrepair. Bathroom wall observed damaged from either water or other; needs repair and fresh paint; Kitchen ceiling lighting observed in disrepair/out of order. This poses a potential health, safety or personal rights risk to persons in care.