Facility Evaluation Report

Licensing Program Analyst (LPA) Olson conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control #29-AS-20230224144738). The purpose of the visit is to issue a citation for deficiencies observed during the complaint investigation.

During the complaint investigation, the following deficiency was observed: Facility Centrally Stored Medication and Destruction Record (CSMDR) records for Resident #1 (R1) were missing the quantity for Vitamin C, Hydrochlorothiazide. The other medication had the total amount listed on the bottle, not actual amount.

CCL received an incident report on 3/9/23 stating Resident 2 (R2) noticed residents Alendronate needed a refill. This is a weekly dosed medication with the refill date to be 3/1/23 but all weekly doses were given. The first dose was given on 3/3/23 and 3 more doses given daily, leaving resident without weekly dose for the month of March.

Citations issued, exit interview, copy of report, appeal rights were printed and emailed.