Pacific Living Centers of Prineville.

“Based on observation and interview, it was determined the facility failed to ensure the kitchen was maintained in accordance with the Food Sanitation Rules OAR 333-150-000. Findings include, but are not limited to: On 12/04/25 at 10:30 am, the facility kitchen was observed to need cleaning and repair in the following areas: a. Food spills, splatters, debris, dirt and black matter was observed on or underneath the following: * Interior and exterior of several drawers and cabinets; * Exterior of trash cans; * Caulking behind the sink; * Flooring perimeter; and * Floor of dry storage closet. b. The following areas needed repair: * The lower cabinet to the right of the oven had a 1X2-inch area with missing laminate, exposing particle board; and * The half-door and adjacent molding, located near the dining room, had chipped and/or worn paint in several areas. The areas in the kitchen which required cleaning and repair were observed and discussed with Staff 1 (Administrator) on 12/04/25. The findings were acknowledged. 1A. All interior and exterior doors and cabinets were cleaned and sanitized, as well as floor in kitchen and pantry. 1B. Laminate replaced on lower cabinet. Half door repainted and chip repair. 2A. All interior and exterior cabinets have been added to deep clean schedule for wednesday NOC (10pm-6am). 2B. Paint and chip repair audits to be done weekly and any concerns added to maintenance log. 3A. Weekly 3B. Weekly 4A. Universal caregiver and Executive Director 4B. Executive Director and Maintenance. OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule (1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). This Rule is not met as evidenced by:”

“Based on observation and interview, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are not limited to: Refer to C 240. See C240 OAR 411-057-0140(2) Administration Compliance (2) The licensee of a memory care community must comply with both the licensing rules for the facility and Chapter 411, Division 57. This Rule is not met as evidenced by:”

“The findings of the Change of Ownership survey, conducted 05/28/24 through 05/30/24, are documented in this report. The survey was conducted to determine compliance with OARs 411 Division 54 for Residential Care and Assisted Living Facilities, OARs 411 Division 57 for Memory Care Communities, and OARs 411 Division 004 Home and Community Based Services Regulations. Tag numbers beginning with the letter C refer to the Residential Care and Assisted Living rules. Tag numbers beginning with the letter Z refer to the Memory Care Community rules. Abbreviations possibly used in this document: ADL: activities of daily living bid: twice a day CBG: capillary blood glucose or blood sugar CG: caregiver cm: centimeter ED: Executive Director F: Fahrenheit HH: Home Health LPN: Licensed Practical Nurse MA:          Medication Aide MAR: Medication Administration Record MCC: Memory Care Community mg: milligram ml: milliliter MT: Medication Technician OT: Occupational Therapist PT: Physical Therapist PRN: as needed qd: every day or daily qid: four times a day QI: quality improvement RCC:       Resident Care Coordinator RN: Registered Nurse TAR: Treatment Administration Record tid: three times a day The findings of the Change of Ownership survey, conducted 05/28/24 through 05/30/24, are documented in this report. The survey was conducted to determine compliance with OARs 411 Division 54 for Residential Care and Assisted Living Facilities, OARs 411 Division 57 for Memory Care Communities, and OARs 411 Division 004 Home and Community Based Services Regulations. Tag numbers beginning with the letter C refer to the Residential Care and Assisted Living rules. Tag numbers beginning with the letter Z refer to the Memory Care Community rules. Abbreviations possibly used in this document: ADL: activities of daily living bid: twice a day CBG: capillary blood glucose or blood sugar CG: caregiver cm: centimeter ED: Executive Director F: Fahrenheit HH: Home Health LPN: Licensed Practical Nurse MA:          Medication Aide MAR: Medication Administration Record MCC: Memory Care Community mg: milligram ml: milliliter MT: Medication Technician OT: Occupational Therapist PT: Physical Therapist PRN: as needed qd: every day or daily qid: four times a day QI: quality improvement RCC:       Resident Care Coordinator RN: Registered Nurse TAR: Treatment Administration Record tid: three times a day The findings of the revisit to the re-licensure survey of 05/30/24, conducted on 09/04/24, are documented in this report. It was determined the facility was in compliance with OARs 411 Division 54 for Residential Care and Assisted Living Facilities, Division 57 for Memory Care Communities, and Home and Community Based Services Regulations OARs 411 Division 004. The findings of the revisit to the re-licensure survey of 05/30/24, conducted on 09/04/24, are documented in this report. It was determined the facility was in compliance with OARs 411 Division 54 for Residential Care and Assisted Living Facilities, Division 57 for Memory Care Communities, and Home and Community Based Services Regulations OARs 411 Division 004.”

“Based on observation, interview, and record review, it was determined the facility failed to have a system in place for accurately tracking controlled substances administered by the facility for 1 of 1 sampled resident (#2) whose medications, MARs, and Controlled Substance Drug Disposition logs were reviewed for accuracy. Findings include, but are not limited to: Resident 2 was admitted to the facility in 03/2024 with diagnoses including Alzheimer's and had a fractured left ankle. Resident 2 had orders for Oxycodone 2.5 mg as needed for severe pain. Review of Resident 2's Controlled Substance Disposition Logs, 05/01/24 to 05/28/24 MARs, and pills, revealed multiple occasions when the disposition logs did not match the MARs. The medication count matched the dispensation logs. The inconsistencies between the MARs and Controlled Substance Disposition logs were reviewed with Staff 2 (Regional Director of Operations) on 05/29/24. She acknowledged the discrepancies. Based on observation, interview, and record review, it was determined the facility failed to have a system in place for accurately tracking controlled substances administered by the facility for 1 of 1 sampled resident (#2) whose medications, MARs, and Controlled Substance Drug Disposition logs were reviewed for accuracy. Findings include, but are not limited to: Resident 2 was admitted to the facility in 03/2024 with diagnoses including Alzheimer's and had a fractured left ankle. Resident 2 had orders for Oxycodone 2.5 mg as needed for severe pain. Review of Resident 2's Controlled Substance Disposition Logs, 05/01/24 to 05/28/24 MARs, and pills, revealed multiple occasions when the disposition logs did not match the MARs. The medication count matched the dispensation logs. The inconsistencies between the MARs and Controlled Substance Disposition logs were reviewed with Staff 2 (Regional Director of Operations) on 05/29/24. She acknowledged the discrepancies.”

“Based on interview and record review, it was determined the facility failed to notify the physician when a resident refused consent to an order, for 1 of 1 sampled resident (#2) with multiple medication and treatment refusals. Findings include, but are not limited to: Resident 2 was admitted to the facility in 03/2024 with diagnoses including Alzheimer's dementia. Resident 2's physician's order and MARs, from 05/01/24 through 05/28/24, were reviewed. Resident 2's practitioner had requested to be notified if orders had been refused for three or more days consistently. Resident 2 had orders for: *Clobetasol Prop 0.05% shampoo to be applied to the scalp every day; *Estradiol 0.01% vaginal cream to be used three times weekly; *Aquaphor ointment to be applied twice daily; *Miconazole AF 2% powder to be applied twice daily for 10 days; *Polyethylene glycol twice daily for three days; and *Nystatin powder to be applied three times daily. Resident 2 refused some or all of the medications and treatments for 24 days. There was no documented evidence each incident of Resident 2's multiple treatment and medication refusals had been reported to the practitioner. The need to notify the practitioner when Resident 2 refused ordered medications and treatments was reviewed with Staff 1 (ED) and Staff 2 (Regional Director of Operations) on 05/29/24. They acknowledged the physician had not been informed of the refusals. Based on interview and record review, it was determined the facility failed to notify the physician when a resident refused consent to an order, for 1 of 1 sampled resident (#2) with multiple medication and treatment refusals. Findings include, but are not limited to: Resident 2 was admitted to the facility in 03/2024 with diagnoses including Alzheimer's dementia. Resident 2's physician's order and MARs, from 05/01/24 through 05/28/24, were reviewed. Resident 2's practitioner had requested to be notified if orders had been refused for three or more days consistently. Resident 2 had orders for: *Clobetasol Prop 0.05% shampoo to be applied to the scalp every day; *Estradiol 0.01% vaginal cream to be used three times weekly; *Aquaphor ointment to be applied twice daily; *Miconazole AF 2% powder to be applied twice daily for 10 days; *Polyethylene glycol twice daily for three days; and *Nystatin powder to be applied three times daily. Resident 2 refused some or all of the medications and treatments for 24 days. There was no documented evidence each incident of Resident 2's multiple treatment and medication refusals had been reported to the practitioner. The need to notify the practitioner when Resident 2 refused ordered medications and treatments was reviewed with Staff 1 (ED) and Staff 2 (Regional Director of Operations) on 05/29/24. They acknowledged the physician had not been informed of the refusals. All residents primary care provider's have been faxed to obtain medication refusal orders and will be added to electronic medication administration record upon receiving orders 2. Medication refusal orders have been added to community new move in orders and get added to electronic medication administration record prior to move in. 3.Upon move in and quarterly with 90 day physician orders 4. Executive Director, Assistant Executive Director All residents primary care provider's have been faxed to obtain medication refusal orders and will be added to electronic medication administration record upon receiving orders 2. Medication refusal orders have been added to community new move in orders and get added to electronic medication administration record prior to move in. 3.Upon move in and quarterly with 90 day physician orders 4. Executive Director, Assistant Executive Director There are no detail notes for this visit.”

“Based on observation and interview, the facility failed to take measures to prevent the entry of insects. Findings include, but are not limited to: The facility was toured with Staff 1 (ED) and Staff 2 (Regional Director of Operations) on 05/28/24. Multiple small flying insects were noted in resident bathrooms and window sills, and in common bathrooms. Staff 1 and 2 acknowledged the presence of the insects. Based on observation and interview, the facility failed to take measures to prevent the entry of insects. Findings include, but are not limited to: The facility was toured with Staff 1 (ED) and Staff 2 (Regional Director of Operations) on 05/28/24. Multiple small flying insects were noted in resident bathrooms and window sills, and in common bathrooms. Staff 1 and 2 acknowledged the presence of the insects. Pointe Pest was called and came out on 5/30/24 and sprayed inside and outside of the community as well as laid granular bait around the community. 2. Pointe Pest will come on a quarterly basis and as needed 3. Every quarter and as needed. 4. Executive Director, Regional Director of Operations Pointe Pest was called and came out on 5/30/24 and sprayed inside and outside of the community as well as laid granular bait around the community. 2. Pointe Pest will come on a quarterly basis and as needed 3. Every quarter and as needed. 4. Executive Director, Regional Director of Operations There are no detail notes for this visit.”

“During the survey, concerns were identified in the following area and the facility was provided with technical assistance: (2) Provider owned, controlled, or operated residential settings must have all of the following qualities: (b) The setting is physically accessible to an individual. During the survey, concerns were identified in the following area and the facility was provided with technical assistance: (2) Provider owned, controlled, or operated residential settings must have all of the following qualities: (b) The setting is physically accessible to an individual. There are no detail notes for this visit.”

“Based on observation and interview, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are not limited to: Refer to C 510. Based on observation and interview, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are not limited to: Refer to C 510. Refer to C510 Refer to C510 There are no detail notes for this visit.”

“Based on observation, interview, and record review, it was determined the facility failed to provide health care services in accordance with the licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are not limited to: Refer to C 302 and C 305. Based on observation, interview, and record review, it was determined the facility failed to provide health care services in accordance with the licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are not limited to: Refer to C 302 and C 305. Refer to C302 and C305 Refer to C302 and C305 There are no detail notes for this visit.”

“The findings of the kitchen inspection, conducted 12/11/23, are documented in this report. It was determined the facility was in substantial compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services- Meals, and Oregon Health Service Food Sanitation Rules OARs 333-150-0000. The findings of the kitchen inspection, conducted 12/11/23, are documented in this report. It was determined the facility was in substantial compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services- Meals, and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.”