Orchid Living LLC.

“Based on documentation review, record review, and interview, the manager failed to ensure that a caregiver who was expected to have more than eight hours per week of direct interaction with residents, provided evidence of freedom from infectious tuberculosis (TB) on or before the date the individual began providing services at or on behalf of the assisted living facility as specified in R9-10-113, for one of two employees sampled. The deficient practice posed a potential 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 the Centers for Disease Control and Prevention website revealed a web page titled, "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005." The web page stated, "If TST (Mantoux Skin Test) is used for baseline testing, two-step testing is recommended for HCWs (Health Care Workers) whose initial TST results are negative. If the first-step TST result is negative, the second-step TST should be administered 1-3 weeks after the first TST result was read." 3. A review of E2's personnel record revealed documentation of a TB skin test that was completed before E2's date of hire, however, a second TB skin test was unavailable. Based on E2's date of hire, this documentation was required. 4. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure that the caregiver documented the services provided in a resident’s medical record according to the resident’s service plan for two out of two residents sampled. The deficient practice posed a risk as services could not be verified as provided against a service plan. Findings include: 1. A review of R1’s medical record revealed a service plan, which included the following: Baths, two times a week. 2. A review of R1’s activities of daily living sheet for March 2026 revealed the following: Baths only given once a week on March 8-14 and March 21-28. 3. A review of R2’s medical record revealed a service plan, which included the following: Skin checks weekly. 4. A review of R2’s activities of daily living sheet for March 2026 revealed the following: Only one skin check was documented on March 1. No other skin check was documented for the entire month. 5. In an exit interview, the findings were reviewed with E1 who reported that the services were provided but not documented properly, and no additional information was provided.”

“Based on documentation review, record review, and interview, the manager failed to ensure that a resident’s medical record contained documentation of notification of the resident of the availability of vaccination for influenza and pneumonia for two of two residents sampled. The deficient practice posed a potential illness risk to residents. Findings include: 1. A.R.S. § 36-406(1)(d) states "The department shall: Require as a condition of licensure that nursing care institutions and assisted living facilities make vaccinations for influenza and pneumonia available to residents on site on a yearly basis. The department shall prescribe the manner by which the institutions and facilities shall document compliance with this subdivision, including documenting residents who refuse to be immunized. The department shall not impose a violation on a licensee for not making a vaccination available if there is a shortage of that vaccination in this state as determined by the director." 2. A review of R1's medical record revealed that a flu and pneumonia vaccine was offered on February 21, 2020. Current documentation of notification of the availability of a vaccination for influenza and pneumonia was not available. Based on R1's date of residency, this document was required. 3. A review of R2's medical record revealed that a flu and pneumonia vaccine was offered on September 15, 2024. Current documentation of notification of the availability of a vaccination for influenza and pneumonia was not available. Based on R2's date of residency, this document was required. 4. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”