Watermark at Continental Ranch.

“Based on record review and interview, the assisted living center failed to maintain a copy of documentation provided to an emergency responder for two years after the date of an emergency, for three of three sampled residents for whom an emergency responder had been contacted on their behalf by the facility. ARS 36-420.04(A-B) states: "A. An assisted living center or assisted living home that contacts an emergency responder on behalf of a resident shall provide to the emergency responder a written document that includes all of the following: 1. The reason or reasons the emergency responder was requested on behalf of the resident. 2. 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. 3. The name, address and telephone number of the resident's current pharmacy. 4. A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive. 5. The name and contact information for the resident's primary care physician and power of attorney or authorized representative. 6. 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. 7. The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address. A point of contact must be available to respond to questions regarding the information provided twenty-four hours a day, seven days a week. 8. 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. This paragraph does not preclude a resident from revoking the resident's health insurance portability and accountability act release authorization. 9. A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home. This paragraph does not preclude a resident from revoking or modifying the resident's advance directives. B. The assisted living center or assisted living home must notify the resident's authorized representative that the resident was transported to a hospital and provide the name and location of the hospital." Findings include: A review of R2's medical record revealed a copy of a form titled "Hospital/Facility Transfer Form," dated March 14, 2026. However, the form did not include a copy of R2'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. A review of R6's medical record revealed an incident report dated January 5, 2026. The incident report indicated an emergency responder was contacted by the facility on R6's behalf and R6 was transported to a hospital. However, a copy of documentation provided to the emergency responders on January 6, 2026, was not available for review. A review of R7's medical record revealed a copy of a form titled "Hospital/Facility Transfer Form," dated December 11, 2025. However, the form did not include the address and telephone number of the R7's current pharmacy or a copy of R7'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. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a service plan was signed by the resident or resident's representative, the manager, and the nurse who reviewed the service plan, when the service plan was initially developed and when the service plan was updated, for four of eight residents sampled. Findings include: A review of R1's medical record revealed a service plan, dated January 6, 2026, for directed care services. Based on R1's date of admission, a completed service plan was required. However, the service plan had not been signed by the resident or resident's representative or the manager. The service plan included a notation that the resident's representative had provided verbal agreement to the service plan. A review of R2's medical record revealed a service plan, dated March 4, 2026, for directed care services. Based on R2's date of acceptance, a completed service plan was required. However, the service plan did not include any signatures. A review of R4's medical record revealed a service plan, dated February 23, 2026, for directed care services. Based on R4's date of acceptance, a completed service plan was required. However, the service plan had not been signed by the resident or resident's representative or the manager. A review of R8's medical record revealed a service plan, dated December 18, 2026, for directed care services. Based on R8's date of acceptance, a completed service plan was required. However, the service plan did not include the manager's signature. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a caregiver or an assistant caregiver documented the services provided in a resident's medical record, for six of eight sampled residents. Findings include: A review of R1's medical record revealed a service plan, dated January 6, 2026, for directed care services. The service plan required the provision of various services, including encouraging R1 to eat meals and snacks and to attend meals, offering water throughout the day, frequent rounds throughout the day and evening for awareness of R1's whereabouts, keeping R1 engaged in meaningful activities to prevent wandering, reminding R1 to wear compression stockings daily, and monitoring skin integrity during daily care, showers, and hygiene. A review of R1's medical record revealed a document titled "Monthly Task Log," dated March 2026. The task log documented the services provided to R1 each day. However, the task log did not include any of the aforementioned services and included only documentation of bathing services and laundry services provided to R1. A review of R2's medical record revealed a service plan, dated March 4, 2026, for directed care services. The service plan required the provision of various services, including encouraging R2 to eat meals and snacks and to attend meals, offering water throughout the day, frequent rounds throughout the day and evening for awareness of R2's whereabouts, keeping R2 engaged in meaningful activities to prevent wandering, and monitoring skin integrity during daily care, showers, and hygiene. A review of R2's medical record revealed a document titled "Monthly Task Log," dated March 2026. The task log documented the services provided to R2 each day. However, the task log did not include the aforementioned services. A review of R3's medical record revealed a service plan, dated February 11, 2026, for directed care services. The service plan required the provision of various services, including encouraging R3 to eat meals and snacks and to attend meals, offering water throughout the day, frequent rounds throughout the day and evening for awareness of R3's whereabouts, keeping R3 engaged in meaningful activities to prevent wandering, and monitoring skin integrity during daily care, showers, and hygiene. A review of R3's medical record revealed a document titled "Monthly Task Log," dated March 2026. The task log documented the services provided to R3 each day. However, the task log did not include any of the aforementioned services and included only documentation of bathing services and laundry services provided to R3. A review of R5's medical record revealed a service plan, dated February 10, 2026, for directed care services. The service plan required the provision of various services, including encouraging R5 to eat meals and snacks and to attend meals, offering water throughout the day, frequent rounds throughout the day and evening for awareness of R5's whereabouts, keeping R5 engaged in meaningful activities to prevent wandering, and monitoring skin integrity during daily care, showers, and hygiene. A review of R5's medical record revealed a document titled "Monthly Task Log," dated March 2026. The task log documented the services provided to R5 each day. However, the task log did not include any of the aforementioned services and included only documentation of bathing services and laundry services provided to R5. A review of R6's medical record revealed a service plan, dated February 11, 2026, for directed care services. The service plan required the provision of various services, including "staff will monitor skin integrity care, showers, hygiene (sic)," "Environmental safety checks will be conducted...," and "R6 does require verbal cue and frequent reminders to maintain hydration due to dementia." A review of R6's medical record revealed a document titled "Monthly Task Log," dated March 2026. The task log documented the services provided to R6 each day. However, the task log did not include any of the aforementioned services. A review of R7's medical record revealed a service plan, dated February 12, 2026, for directed care services. The service plan required the provision of various services, including encouraging R7 to eat meals and snacks and to attend meals, offering water throughout the day, frequent rounds throughout the day and evening for awareness of R7's whereabouts, keeping R7 engaged in meaningful activities to prevent wandering, and monitoring skin integrity during daily care, showers, and hygiene. A review of R7's medical record revealed a document titled "Monthly Task Log," dated March 2026. The task log documented the services provided to R7 each day. However, the task log did not include any of the aforementioned services. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a service plan for a resident receiving directed care services included the requirements in R9-10-814(F)(1) through (2), and coordination of communications with the resident’s representative, family members, and, if applicable, other individuals identified in the resident’s service plan, for two of eight sampled residents receiving directed care services. Findings include: A review of R4's medical record revealed a service plan, dated February 23, 2026, for directed care services. However, the service plan did not include skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections, offering sufficient fluids to maintain hydration, or coordination of communications with the resident’s representative, family members, and, if applicable, other individuals identified in the resident’s service plan. A review of R8's medical record revealed a service plan, dated December 18, 2025, for directed care services. However, the service plan did not include skin maintenance to prevent and treat bruises, injuries, pressure sores, and infections, offering sufficient fluids to maintain hydration, or coordination of communications with the resident’s representative, family members, and, if applicable, other individuals identified in the resident’s service plan. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure the service plan for a resident receiving memory care services included an identification of specialized environmental features to support memory care services, such as secure areas to prevent wandering and spaces designed for cognitive stimulation and engagement, for six of six sampled residents receiving memory care services. Findings include: A review of R1's, R2's, R3's, R5's, R6's, and R7's medical records revealed each resident had a current service plan and was receiving memory care services. However, the service plans did not include documentation of an identification of specialized environmental features to support memory care services, such as secure areas to prevent wandering and spaces designed for cognitive stimulation and engagement, specific to each resident's needs. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure the service plan for a resident receiving memory care services included strategies for providing person-centered care that aligned with the principles of dementia-friendly environments, including familiar surroundings, optimized sensory stimulation, and meaningful activities, for six of six sampled residents receiving memory care services. Findings include: A review of R1's, R2's, R3's, R5's, R6's, and R7's medical records revealed each resident had a current service plan and was receiving memory care services. However, the service plans did not include documentation of strategies for providing person-centered care that aligned with the principles of dementia-friendly environments, including familiar surroundings, optimized sensory stimulation, and meaningful activities, specific to each resident's needs. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure the service plan for a resident receiving memory care services included strategies for administering medications as ordered, for six of six sampled residents receiving memory care services. Findings include: A review of R1's, R2's, R3's, R5's, R6's, and R7's medical records revealed each resident had a current service plan and was receiving memory care services. However, the service plans did not include documentation of strategies for administering medications as ordered, specific to each resident's needs. In an exit interview with E1, the findings were reviewed and no additional information was provided.”

“Based on record review and interview, service planning for residents receiving memory care services failed to include comprehensive assessments for six of six sampled memory care residents. Findings include: A review of R1's medical record revealed a service plan, dated January 6, 2026, for directed care services. The service plan included a diagnosis of "Alzheimer's disease with early onset." However, a comprehensive assessment was not available for review. A review of R2's medical record revealed a service plan, dated March 4, 2026, for directed care services. The service plan included a diagnosis of "Dementia." However, a comprehensive assessment was not available for review. A review of R3's medical record revealed a service plan, dated February 11, 2026, for directed care services. The service plan included a diagnosis of "Unspecified dementia, unspecified severity, without behavioral disturbance." However, a comprehensive assessment was not available for review. A review of R5's medical record revealed a service plan, dated February 10, 2026, for directed care services. The service plan included a diagnosis of "Unspecified Dementia." However, a comprehensive assessment was not available for review. A review of R6's medical record revealed a service plan, dated February 11, 2026, for directed care services. The service plan included a diagnosis of "Alzheimer's disease with late onset." However, a comprehensive assessment was not available for review. A review of R8's medical record revealed a service plan, dated December 18, 2025, for directed care services. The service plan included a diagnosis of "Dementia in other diseases classified elsewhere." However, a comprehensive assessment was not available for review. In an exit interview with E1, the findings were reviewed and no additional information was provided.”