Caissa Assisted Living Home Inc..

“Based on record review and interview, the assisted living home failed to provide an emergency responder with a written document that included the requirements in A.R.S. 36-420.04.A.1-9 for one of three residents sampled. The deficient practice posed a risk if the emergency responder was not aware of critical health information for the resident. Findings include:  1. A review of R1’s medical records revealed an incident report dated January 23, 2026; however, there was no documentation provided to emergency services using a standardized form that included the following: The reason or reasons the emergency responder was requested on behalf of the resident;  Whether the resident receives medication services and, if the resident has provided this information to the assisted living center or assisted living home, a list of all the resident's prescription and over-the-counter medications, their dosages and how frequently they are administered; The name, address and telephone number of the resident's current pharmacy; A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive; The name and contact information for the resident's primary care physician and power of attorney or authorized representative; Basic information about the resident's physical and mental conditions and basic medical history, such as having diabetes or a pacemaker or experiencing frequent falls or cardiovascular and cerebrovascular events, as well as dates of recent episodes, if known; The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address. A point of contact must be available to respond to questions regarding the information provided twenty-four hours a day, seven days a week; A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge. This paragraph does not preclude a resident from revoking the resident's health insurance portability and accountability act release authorization; A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home. This paragraph does not preclude a resident from revoking or modifying the resident's advance directives. 2. In an exit interview, findings were reviewed with E1, and no additional information was provided.”