Premier Assisted Living LLC.

“Based on record review and interview, the assisted living home failed to maintain a standardized form for each resident that includes the information prescribed in A.R.S. § 36-420.04.A.1-9 for two out of two residents sampled. The deficient practice posed a risk if the facility was not prepared in case of an emergency. Findings include: 1. A review of R1's medical record revealed there was a standardized form to be used if an emergency responder was contacted, however, the form was missing the following information: 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. 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 name and contact information for the resident's primary care physician and power of attorney or authorized representative. The point-of-contact information for the assisted living center or assisted living home, as well as the telephone number, if available, cell phone number and email address; and 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. 2. A review of R2's medical record revealed there was a standardized form to be used if an emergency responder was contacted, however, the form was missing the following information: The name, address and telephone number of the resident's current pharmacy. 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. The point-of-contact information for the assisted living center or assisted living home, as well as the telephone number, if available, cell phone number and email address; and 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. 3. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on interview and documentation review, the health care institution failed to ensure that the health care institution implemented tuberculosis (TB) infection control activities that included annually providing training and education related to recognizing the signs and symptoms of TB to individuals employed by or providing volunteer services for the health care institution for two of two employees sampled and annually assessing the health care institution's risk of exposure to infectious TB. Findings include: 1. In an interview, E1 reported that the facility conducts the annual training for tuberculosis infection control. 2. A review of E1's personnel record revealed training and education related to recognizing the signs and symptoms of TB completed on December 4, 2024. No further training was available. 3. A review of E2's personnel record revealed no documentation of training and education related to recognizing the signs and symptoms of TB. Based on E2's date of hire, this information was required. 4. A review of the facility's documentation revealed that an annual assessment of the health care institution's risk of exposure to infectious tuberculosis was unavailable for review. 5. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on documentation review, observation, and interview, the manager failed to ensure that there was a means of exiting the facility for a resident who did not have a key, special knowledge for egress, or the ability to expend increased physical effort that provided access to an outside area that allowed the resident to be at least 30 feet away from the facility that was secure and provided access to an outside area that monitored or alerted employees of the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident. Findings include: 1. A review of the facility license revealed the facility was licensed at the directed care level. 2. During an environmental inspection of the facility with E1, the Compliance Officer observed the backyard area allowed a resident to be at least 30 feet away from the facility. The gate in the backyard was not secured. 3. 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 a medication administered to a resident was administered in compliance with a medication order, for one of the two residents sampled. The deficient practice posed a risk as medication administration could not be verified against a medication order. Findings include: 1. A review of R2's service plan dated March 1, 2026 revealed R2 received medication administration. 2. A review of R2’s medical record revealed signed medication orders dated January 14, 2026. These medication orders stated: Lamotrigine 150mg 1 tab po QD Fesoterodine 4mg 1 tab po QD Fluoxine 20mg 1 tab po BID No signed medication orders were available for Famotidine 40 mg and Ipatropium/Sol Albuterol 3. A review of R2's medical record revealed a March 2026 medication administration record (MAR). This MAR revealed the following: No documentation showing Lamotidine 150mg and Fesoterodine 4mg were administered. Fluoxine 20mg 1 tab po BID. However, this medication was only administered once a day at 8am from March 1-31, 2026. Famotidine 40 mg, 1 tab PO. This medication was administered from March 6-31, 2026. Ipatropium/Sol Albuterol, 1 vial every 4 hours as needed for cough. This medication was administered from March 6-26, 2026. 4. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on observation and interview, the manager failed to ensure that the premises were cleaned and, if applicable, disinfected according to policies and procedures designed to prevent, minimize, and control illness or infection. 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 Officer observed a bathroom in the bedroom of R4. This bathroom had dried, brown substances all over the toilet, the back of the toilet, all over the floors, on the walls and on the light switch. 2. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on observation and interview, the manager failed to ensure that garbage and refuse were stored in covered containers. The deficient practice posed a risk to the health and safety of the residents as an uncovered garbage container can lead to the possibility of infection. Findings include: 1. During an environmental inspection of the facility, the Compliance Officer observed a bathroom in the bedroom of R4. This bathroom had an uncovered trash can filled with large napkins that were wrapped around a dried, brown substance. 2. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on observation and interview, the manager failed to ensure that oxygen containers were secured in an upright position. The deficient practice posed a potential explosion or leak of a compressed gas. Findings include: 1. During an environmental inspection of the facility, the Compliance Officer observed three oxygen tanks in the bedroom of R3 that were standing in an upright position; however, neither oxygen tank was properly secured. 2. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on observation and interview, the manager failed to ensure that at least one bathroom is accessible from a common area and contained a window that opened or another means of ventilation. Findings include: 1. During an environmental tour of the facility, the Compliance Officer observed a bathroom in the bedroom of R4. This bathroom had no window and no means of ventilation. 2. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on record review, observation, and interview, the manager failed to ensure a medication was administered in compliance with a medication order, for one of two residents reviewed. The deficient practice posed a risk if the resident experienced a change in condition due to improper administration of medication. Findings include: 1. Review of R2's medical record revealed a current written service plan dated June 16, 2023. This service plan indicated R2 received medication administration. 2. Review of R2's medical record revealed a signed medication order dated September 18, 2023. This medication order stated "Gabapentin 100mg 2 tabs po three times daily". 3. Review of R2's medical record revealed a December 2023 medication administration record (MAR). This MAR stated "Gabapentin 300mg 1 tab PO TID" and indicated one tab was administered at 8am, 2pm, and 8pm December 1st - present. 4. During an observation of R2's medications, Gabapentin 300mg was observed and one tab was observed prefilled in R2's medication organizer three times a day. 5. In an interview, E1 reported the medication was administered per the medication organizer and acknowledged R2's medication was not administered in compliance with the available medication order.”

“Based on observation and interview, the manager failed to ensure toxic materials stored by the facility were stored in a locked area and 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 with E1, the Compliance Officer observed Fabuloso, Kroger bleach, and Bona multi surface floor cleaner unlocked in a cabinet in the kitchen sink. This cabinet had a locking device, however the device was not locked. 2. During an observation, the caregivers were not accessing the toxic materials at the time of arrival. 3. In an interview, E1 acknowledged toxic materials were stored unlocked.”