Aspen Park of Cascadia

Inspectors wroteBased on observation, record review, and interviews it was determined the facility failed to ensure residents were able to use their personal property as needed. This was true for one of one resident (Resident #35) reviewed for residents' rights. This deficient practice created the potential for Resident #35 to experience a violation of her right to use her personal property, loss of trust in staff, and emotional distress when staff changed the orientation of the batteries in her remote control.

Inspectors wroteBased on interviews and record review, it was determined the facility failed to ensure residents were provided with a safe, comfortable, and homelike environment. This was true for one of one resident (Resident #10) reviewed for quality of life, whose sleep was affected by her roommate's loud television (TV) volume. This failure created the potential for Resident #10 to be deprived of sleep, affecting comfort and overall well-being.

Inspectors wroteBased on review of records, policy review, and resident and staff interviews, it was determined the facility failed to ensure an ongoing resident's concern was recognized and addressed as a grievance. This was true for one of one resident (Resident #10) whose ongoing concern regarding her roommate's TV volume was not addressed. This deficient practice had the potential to negatively affect Resident #10's quality of life and satisfaction with care.

Inspectors wroteBased on policy review, record review, and interviews, it was determined the facility failed to ensure residents' care plan interventions were implemented as written. Specifically, staff did not follow the resident's care plan regarding the management of his hearing aid and the required storage of his smoking paraphernalia. This was true for 1 of 1 resident (Resident #36) whose care plan was reviewed. This failure created the potential for unmet needs, safety concerns, and a decline in Resident #36's physical and psychosocial well being.a. Resident #36 was admitted to the facility on [DATE], with multiple diagnoses including unspecified hearing loss, stroke, and hypertension. [...]

Inspectors wroteBased on record review, policy review, observations, and staff interviews, the facility failed to ensure indwelling catheter care was implemented for 1 of 1 resident (Resident #19) whose records were reviewed for catheter care. This failure created the potential for Resident #19 to not receive appropriate catheter care to his suprapubic catheter.

Inspectors wroteBased on observation, resident and staff interviews, and record review, it was determined the facility failed to ensure 1 of 2 residents (Resident #44) received oxygen via nasal cannula as prescribed by the physician. This deficient practice created the potential for Resident #44 to experience respiratory difficulties or impaired breathing.

Inspectors wroteBased on record review and staff interview, it was determined the facility failed to ensure a resident was adequately monitored for medication side-effects. This was true for 1 of 6 residents (Resident #37) whose records were reviewed for unnecessary medications. This failure placed Resident #37 at risk for harm if they were to suffer from side-effects of a medication due to a lack of monitoring.

Inspectors wroteBased on record review, policy review, observations, and staff interviews it was determined that the facility failed to ensure completed medications were properly discarded for 1 of 2 medication carts reviewed. This failure created the potential for medication errors to occur.

Inspectors wroteBased on observation, record review, and staff interview, it was determined the facility failed to ensure residents were assessed to determine if they were safe to self-administer medications. This was true for 1 of 2 residents (Resident #1) reviewed for self-administration of medication. This failure created the potential for adverse outcomes if Resident #1 was to self-administer oral medications inappropriately.

Inspectors wroteBased on record review and staff interview it was determined the facility failed to ensure residents exercised their right to formulate an Advanced Directive. This was true for 1 of 14 residents (Resident #39) whose records were reviewed. This failed practice created the potential for an adverse outcome if the resident's wishes were not followed.

Inspectors wroteBased on review of the Resident Assessment Instrument (RAI) Manual, record review, and staff interview, it was determined the facility failed to ensure a residents Minimum Data Set assessment included correct information. This was true for 1 of 14 residents (Resident #4) whose records were reviewed for accuracy. This deficient practice had the potential for negative outcomes if residents were not monitored due to inaccurate assessments.

Inspectors wroteBased on record review and staff interview, it was determined the facility failed to ensure services provided met the professional standards. This was true for 3 of 14 residents (#19, 27, and 44) whose physician orders were reviewed. This failure created the potential for residents to suffer harm from adverse effects during medication administration.

Inspectors wroteBased on record review and staff interview it was determined the facility failed to ensure professional standards of practice were followed for 1 of 14 residents (Resident #33) reviewed for bowel management. This failure created the potential for adverse outcomes when Resident #33's physician orders were not followed for bowel management.

Inspectors wroteBased on record review and staff interview, it was determined the facility failed to ensure appropriate dementia care planning was implemented. This was true for 1 of 14 resident (Resident #7) whose record was reviewed for care planning. This failure placed Resident #7 at risk for her needs to go undetected when her care plan did not include services to maintain her highest practicable physical, mental, and psychosocial well-being.

Inspectors wroteBased on observation and staff interview it was determined the facility failed to ensure infection control practices were implemented during medication observation. This had the potential to affect all residents in the facility when LPN #1 dropped an oral tablet and picked it up with her ungloved hand.

Inspectors wroteBased on observation and staff interview, it was determined the facility failed to ensure kitchen equipment was maintained and food was stored in a safe and sanitary manner. These deficiencies had the potential to affect the 40 residents residing in the facility who consumed food prepared by the facility. This placed residents at risk for potential contamination of food and adverse health outcomes, including food-borne illnesses.