Touchmark at the Ranch, LLC.

“Based on documentation review and interview, the manager failed to develop a training program for all staff regarding fall prevention and fall recovery, including initial and continued training. Findings include: 1 . A review of facility documentation revealed a written program which stated when personnel received initial training and continued competency training for fall prevention and fall recovery was not available for review at the time of inspection. 2 . In an exit interview, the findings were discussed with E1 and no additional information was provided. 3. This is a repeat deficiency from the compliance inspection conducted September 12, 2023.”

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were inaccessible to residents. Findings include: 1 . During an environmental inspection of the facility, the Compliance Officers observed a "Supply" room with the door open. Inside the room was an unlocked cabinet with the following chemicals: -A bottle of "Pill Disposal XL"; -A bottle of laundry stain remover; -A bottle of "Great Value" low splash bleach; -A bottle of "Top Clean"; and -A bottle of "Expo" whiteboard cleaning spray. 2 . During an environmental inspection of the facility, the Compliance Officers observed an unlocked laundry room in the memory care unit. The room had an "AccuMax 4P" dispensing system with an open tube, which included bathroom cleaner and disinfectant options. 3 . During an environmental inspection of the facility, the Compliance Officers observed an unlocked cabinet under a sink in the memory care unit common area kitchen. The cabinet contained the following chemicals: -A bottle of "Butler" disinfectant spray; -A bottle of "Suprox-D"; and -A bottle of "Take Down." 4 . During an environmental inspection of the facility, the Compliance Officers observed an unlocked cabinet under a sink in a common area kitchen. The cabinet contained the following chemicals: -A bottle of "Suprox-D"; -A can of stainless steel cleaner and polish; and -A bottle of "Super Shine-All." 5 . In an exit interview, the findings were discussed with E1 and no additional information was provided.”

“Based on record review and interview, the Manager failed to ensure that a resident was treated with dignity, respect and consideration. Findings include: 1. Review of the record for E2 revealed a "Written Disciplinary Warning" dated April 2, 2024 that indicated E2 had been involved in an incident with R1 on March 27, 2024 where E2 had not treated R1 with "respect". 2. During an interview, E1 stated, "I listened to the video and I didn't like his tone of voice, it was unkind." 3. During an interview, E1 acknowledged E2 failed to treat R1 with dignity, respect and consideration.”

“Based on documentation review and interview, the manager failed to ensure that a fire inspection was conducted by the local fire department or the State Fire Marshal according to the time-frame established by the local fire department or the State Fire Marshal. Findings include: 1. Facility documentation indicated the last fire inspection was conducted by the local fire department on April 29, 2022. 2. During an interview with a representative from the local Fire Department it was determined that fire inspections are required on an annual basis. 3. During an interview, E1 stated, "We have a local fire protection company inspect us annually." 4. During an interview, E1 acknowledged that the required fire inspection was not conducted as required.”

“Based on record review and interview, the manager failed to ensure that the health care institution implemented tuberculosis infection control activities that included annually providing training and education related to recognizing the signs and symptoms of tuberculosis (TB) to individuals employed by the health care institution. Findings include: 1. Review of the record for E1 indicated that the last documentation indicating that annual TB training had been conducted was on January 25, 2023. 2. Review of the record for E2 indicated that the last documentation indicating that annual TB training had been conducted was on June 5, 2023. 3. During an interview, E1 acknowledge that the required documentation was not available.”

“Based on record review and interview, the manager failed to ensure that medication administered to a resident was administered in compliance with a medication order. Findings include: 1. Review of the record for R2 revealed that on September 26, 2023 at approximately 8pm, the resident failed to receive the following prescribed medications: Metoprolol 25mg, Potassium Chloride 20mEq, Warfarin 2.5mg, and Pravastatin 20mg. Instead the resident received the following medications prescribed to R4: Atorvastatin 40mg, Mirtazapine15mg, and Quetiapine 25mg. 2. During an interview, E1 stated, "The resident was given another resident's medications by mistake." 3. During an interview, E1 acknowledged that medication prescribed to the resident was not administered in compliance with the medication order.”