Abaca Health II, LLC.

“Based on documentation review, record review, and interview, the manager failed to ensure a manager provided current documentation of first aid training and cardiopulmonary resuscitation (CPR) training certification specific to adults before providing assisted living services to a resident, for one of one total manager. The deficient practice posed a risk as a manager was unable to meet a resident's needs during an emergency. Findings include: 1. A review of facility documentation revealed a policy and procedure (P&P) titled “FIRST AID/CPR TRAINING REQUIREMENTS.” The P&P stated: “Assisted living facilities are required that facility staff members who provide care for residents, should have completed courses in First Aid and CPR and hold a currently valid card documenting completion of such courses in the facility at all times. 2. A review of facility documentation revealed a series of personnel schedules which indicated E2 worked on a weekly basis between September 6, 2025, and the date of the inspection. 3. A review of E2’s personnel record revealed E2 was hired as the manager. The review revealed documentation of CPR training certification. However the training certification expired at the end of August 2025. The review revealed no current documentation of CPR training certification. 4. In an interview, E3 reported not knowing whether E2 had current documentation of CPR training certification. 5. In the exit interview, the Compliance Officer reviewed the findings and E3, and E3 offered no further comment.”

“Based on record review, observation, and interview, the manager failed to ensure a medication was administered in compliance with a medication order, for two of two sampled residents. The deficient practice posed a risk if the resident experienced a change in condition due to improper administration of medication. Findings include: 1. A review of R1’s medical record revealed a current service plan which indicated R1 received medication administration. The review revealed the following medication orders: - “[F]entanyl 50 mcg/hr transdermal patch…1 patch transdermal…EVERY 72 HOURS…APPLY WITH A 100MCG PATCH FOR A TOTAL OF 150MCG,” dated February 3, 2026; - “[F]entanyl 100 mcg/hr transdermal patch…1 patch transdermal…EVERY 72 HOURS…APPLY WITH A 50MCG PATCH FOR A TOTAL OF 150MCG,” dated February 3, 2026; - “LORAZEPAM 0.5MG PO/SL QAM,” dated January 27, 2026; and - “Trazodone 100mg qhs po,” dated February 19, 2026; The review further revealed a medication administration record (MAR) dated March 2026. The MAR revealed the following: - R1 received R1’s fentanyl patches totalling 150 mcg at 1:00 PM on March 11, 2026, then not again until 96 hours later at 1:00 PM on March 15, 2026; - R1 received 1 mg of lorazepam at 8:00 PM on March 1-26, 2026, instead of 0.5 mg in the morning as ordered; and - No documentation demonstrating R1 received R1’s trazodone. 2. A review of R2’s medical record revealed a current service plan which indicated R2 received medication administration. The review revealed medication orders for “Fentanyl Transdermal Patch 72 hour 75mcg / HOUR Apply 1 patch every 72 hours,” “Meloxicam 25mg 1 tablet by mouth 1 x a day,” and “Triazolam 0.25mg 1 tablet by mouth 1 x a day”dated July 30, 2025. The review further revealed a MAR dated March 2026. The MAR revealed the following: - R2 received R2’s fentanyl patch at 5:00 PM on March 5, 2026, then not again until 96 hours later at 5:00 PM on March 8, 2026; - R2 received 15 mg of meloxicam on March 1-27, 2026, instead of 25 mg as ordered; and - R2 received three tablets of triazolam on March 1-26, 2026, instead of one tablet of triazolam as ordered. 3. The Compliance Officer observed R2’s medications. The Compliance Officer observed a pharmacy-provided bottle of meloxicam 15 mg instead of meloxicam 25 mg as ordered and a pharmacy-provided multi-dose package of triazolam 0.25 mg with three tablets in each bubble. 4. In the exit interview, the Compliance Officer reviewed the findings and E3, and E3 offered no comment.”

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were maintained in a locked area inaccessible to residents. The deficient practice posed a risk to the physical health and safety of residents. Findings include:  1. The Compliance Officer observed an unlocked cabinet under the sink in the kitchen. Inside the cabinet, the Compliance Officer observed a variety of poisonous or toxic materials, including air freshener, Comet, disinfectant, and insect repellant. In a hall bathroom, the Compliance Officer observed an unlocked cabinet under the sink. In the cabinet, the Compliance Officer observed air freshener and disinfectant. 2. In an interview, E3 acknowledged the cabinets were not locked. 3. In the exit interview, the Compliance Officer reviewed the findings and E3, and E3 offered no further comment. Technical assistance was provided on this rule during the initial monitoring inspection conducted on September 3, 2024.”