The Meridian at Stone Creek.

—: The assisted living facility failed to ensure completion of the required national fingerprint background check for named staff.

WAC 388-78A-2770: The facility failed to notify the Department of a change in ownership/licensee. The facility was licensed under Meridian Milton LLC (UBI #603 476 829), which was administratively dissolved on 07/01/2016, but the facility continued operating under different entities including Pacifica Senior Living Milton LLC and Milton Meridian LLC (UBI #605 935 574) without notifying the Department, placing all 67 residents at risk from receiving services from an unqualified licensee.

WAC 388-78A-2371: The facility failed to document investigative findings and actions for allegations of abuse and neglect involving 3 residents who were found wet with urine for extended periods. The facility did not maintain incident reports or document the results of investigations, creating gaps in accountability and oversight. WAC 388-78A-3040: The facility's commercial washing machines were non-functional and staff used residential washing machines that lacked continuous hot water supply at 140°F and did not automatically dispense chemical sanitizers. This failure to meet proper disinfection standards placed residents at risk of infection and cross-contamination. WAC 388-78A-2600: The facility failed to follow its own alert charting policy when a resident reported being touched inappropriately. Staff did not complete alert charting entries for each shift as required by policy, placing the resident at risk of not receiving necessary care for potential psychological harm.

WAC 388-78A-2610: The facility failed to ensure 2 of 2 staff (Staff A & B) were qualified to medically evaluate staff prior to fit testing. Staff A (Executive Director) and Staff B (LPN) conducted medical evaluations and fit tested 23 staff without proper credentials as a licensed health care professional (LHCP), placing all residents and staff at risk of infection exposure during a communicable disease outbreak. WAC 388-78A-2610: The facility failed to ensure a supply of respirators were available for use and staff were fit tested during an outbreak of an infectious disease. Observation on 06/20/2024 showed a storage room contained face shields, gowns, and COVID test kits, but no N-95 respirators. Staff reported the facility had run out of respirators during the most recent outbreak.

WAC 388-78A-3090: The facility failed to maintain a safe and sanitary environment. WAC 388-78A-2130(1)(a)(b)(c): The facility failed to develop an initial service plan for a resident. WAC 388-78A-2130: The facility failed to develop a care plan and failed to have care plans signed by the resident or their representative. —: A consultation was written for failing to secure an order prior to the administration of a topical medication. —: Citations were written for staff who failed to have required training documents. WAC 388-78A-2305(1): The facility failed to maintain a sanitary environment in the kitchen. WAC 388-78A-3090(1)(a,c,d): The facility failed to provide adequate maintenance and housekeeping services. WAC 388-78A-2120-4: The facility failed to take appropriate action when a resident sustained an open area to their buttocks. WAC 388-78A-2220: The facility failed to have proper prescribed medication authorizations before providing medication assistance or medication administration to residents.

—: The assisted living facility failed to report to the department when the facility's boiler system no longer worked to keep water temperatures between 105 and 120 degrees Fahrenheit. —: The assisted living facility failed to ensure the exterior grounds were sanitary and kept in good repair.

—: The facility failed to complete a proper assessment of the resident when there was a change of condition. Specifically, the facility did not adequately assess the resident's wound despite taking some measures to manage it. —: The resident's wound dressing was not changed according to the scheduled care plan.

WAC 388-78A-2483: The facility failed to ensure 2 of 5 staff (Staff C and D) completed the required tuberculosis testing for new employees. Staff C was hired on 04/03/2023 with only one negative TB test on that date and no documentation of a two-step test. Staff D was hired on 03/15/2023 with only one negative TB test on that date and no documentation of a two-step test. This failure placed all 74 residents at health risk of TB, a communicable disease.