Bee Hive Homes of Arrowhead.

“Based on record review and interview, the governing authority failed to ensure compliance with Arizona Revised Statutes (A.R.S.) § 36-411(C), for two of two sampled employees. Findings include: 1. A.R.S. § 36-411(C)(3) states: "C. Each residential care institution, nursing care institution and home health agency shall make documented, good faith efforts to: 3. Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459.” 2. A review of E1's personnel record revealed no documentation of the facility checking if the employee was not on the adult protective registry. 3. A review of E2's personnel record revealed no documentation of the facility checking if the employee was not on the adult protective registry. 4. In an interview, E1 reported that they were not aware of the new rule, and none of the caregivers would have it done.”

“Based on documentation review, record review, and interview, the manager failed to ensure a personnel record for each employee or volunteer included documentation of evidence of freedom from infectious tuberculosis (TB), as specified in R9-10-113, for one of two personnel sampled.      Findings include:     1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. A review of E2's personnel record revealed a document titled "Two-Step Tuberculin Skin Test Form", but there was no documentation of signs, symptoms, and risk assessment. 3. In an interview, E1 acknowledged that E2 did not have documentation of evidence of freedom from infectious tuberculosis.”

“Based on documentation review, record review, and interview, the manager failed to ensure a resident provided evidence of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for two of two residents sampled. The deficient practice posed a TB exposure risk to residents.   Findings include:   1. R9-10-113.A states, "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. A review of R1's medical record revealed a document titled "Tuberculin Test PPD Skin Test" with a negative test, but no documentation of signs, symptoms, and risk assessment. 3. A review of R2's medical record revealed a document titled "Tuberculin Test PPD Skin Test" with a negative test, but no documentation of signs, symptoms, and risk assessment. 4. In an interview, E1 acknowledged that R1 and R2 did not have proper documentation of freedom from tuberculosis.”

“Based on documentation review and interview, the manager failed to ensure when a resident had an accident, emergency, or injury that resulted in the resident needing medical services, a caregiver or an assistant caregiver documented the names of individuals who observed the accident, emergency, or injury, and documented any action taken to prevent the accident, emergency, or injury from occurring in the future. The deficient practice posed a risk if the facility did not take steps to ensure the health and safety of a resident. Findings include: 1. A review of facility documentation revealed an incident report dated December 17, 2023. The report revealed R2 was in a reclining chair and fell after R2 tried to get up and walk away. The report indicated R2's hospice nurse was notified and ordered x-rays. Additionally, the report stated, "Late entry dec 20 [December 20, 2023] Possible fx [fracture to the] right hip right shoulder fx [fracture]." However, the report did not include the names of individuals who observed the accident, and the report did not document any action taken to prevent the accident from occurring in the future. 2. A review of facility policies and procedures (P&P) revealed a P&P titled, "Incident Reports". However, the P&P did not include a procedure on documenting and collecting information required in Arizona Administrative Code (A.A.C.) R9-10-818(D)(2). 3. In an interview, E1 and E4 acknowledged a caregiver or an assistant caregiver did not document the names of individuals who observed the accident, emergency, or injury, and did not document any action taken to prevent the accident, emergency, or injury from occurring in the future.”