Highland Assisted Living LLC.

“Based on record review and interview, the manager failed to ensure that before or at time of acceptance of an individual submitted documentation that was dated within 90 calendar days before the individual was accepted by an assisted living facility and included whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints and was signed and dated by a medical practitioner, for one of two residents sampled. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include:  1. A review of R2's medical record revealed a document titled "Determination for Residency or Continued Residency." This document contained whether or not R2 required continuous medical services, continuous or intermittent nursing services, or restraints and was signed and dated by a registered nurse or medical practitioner. However, the form was not signed before R2’s date of admission to the facility.  2. In an interview, E1 acknowledged R2's medical record did not contain the required documentation that was dated 90 days before R2 was accepted by the facility.”

“Based on record review and interview, the manager failed to ensure that a resident had a written service plan that included the amount, type, and frequency of assisted living services being provided to the resident, for one of two residents sampled. Findings include:  1. A review of R1’s medical record revealed a service plan, dated March 10, 2025. R1’s service plan revealed R1 required the following services:  Standby assistance with dressing;  Full assistance with dressing;  Standby assistance with socks and shoes;  Full assistance with socks and shoes;  Standby assistance with clothing;  Full assistance with clothing;  Standby assistance with picking out clothes;  Full assistance with picking up clothes;  Independent with grooming; and Dependent with grooming. 2. In an interview, E1 reported R1 required the full assistance indicated on R1’s service plan. E1 acknowledged R1’s service plan did not include the amount and type of assisted living services provided to R1.”

“Based on documentation review and interview, the manager failed to ensure that a current toxicology reference guide was available for use by personnel members. Findings include: 1. A review of the facility's toxicology reference guide revealed a publishing year of 2015. However, documentation of a current toxicology reference guide was not available for review. 2. In an interview, E1 acknowledged a current toxicology reference guide was not available for use by personnel members.”

“Based on observation, documentation review, and interview, the manager failed to ensure the premises were free from a condition or situation that may cause a resident or other individual to suffer physical injury. The deficient practice posed a health and safety risk to the residents.  Findings include:   1.    During an environmental inspection of the facility, the Compliance Officers observed a garden hose in the backyard walkway. 2.    During an environmental inspection of the facility, the Compliance Officers observed a Hoyer lift in the backyard area. 3.    During an environmental inspection of the facility, the Compliance Officers observed a wooden structure, that had nails and staples sticking out. 4.    A review of the facility's policies and procedures titled "Environmental Safety" revealed "A manager shall ensure that the premises and equipment used at the assisted living facility are free from a condition or situation that may cause a resident or other individual to suffer physical injury;"  5.    In an interview, E1 acknowledged the backyard area was not free from a condition or situation that may cause a resident or other individual to suffer physical injury.”

“Based on observation, documentation review, and interview, the manager failed to ensure combustible or flammable liquids and hazardous materials were stored by the assisted living facility in the original labeled containers or safety containers in a locked area inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include:   1.    During an environmental inspection of the facility, the Compliance Officers observed two propane tanks in the backyard area. 2.    A review of the facility's policies and procedures titled "Environmental Safety" revealed "Combustible or flammable liquids and hazardous materials stored by the assisted living facility are stored in the original labeled containers or safety containers in a storage area that is locked and inaccessible to residents."  3.    In an interview, E1 acknowledged combustible or flammable liquids were accessible to residents.”