| Facility failed to meet the following Requirement(s): | Corrected Date | Level of Harm | Residents Affected |
| Staffing Requirements.
(A) The facility shall have an adequate number and type of personnel for the proper care of residents and upkeep of the facility. At a minimum, the staffing pattern for fire safety and care of residents shall be one (1) staff person for every fifteen (15) residents or major fraction of fifteen (15) during the day shift, one (1) person for every fifteen (15) residents or major fraction of fifteen (15) during the evening shift, and one (1) person for every twenty (20) residents or major fraction of twenty (20) during the night shift. I/II
Time Personnel Residents
7 a.m. to 3 p.m.
(Day)* 1 3-15
3 p.m. to 9 p.m.
(Evening)* 1 3-15
9 p.m. to 7 a.m.
(Night)* 1 3-20
*If the shift hours vary from those indicated, the hours of the shifts shall show on the work schedules of the facility and shall not be less than six (6) hours. III
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11/4/2024
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| The licensed nurse shall be available to assess residents for pain and significant and acute changes in condition. The nurse ' s duties shall include, but shall not be limited to, review of residents ' records, medications, and special diets or other orders, review of each resident ' s adjustment to the facility, and observation of each individual resident ' s general physical, psychosocial, and mental status. The nurse shall inform the administrator of any problems noted and these shall be brought to the attention of the resident ' s physician and legally authorized representative or designee. II/III
ALFI |
11/4/2024
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| Residents shall receive proper care as defined in the individualized service plan. I/II
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11/4/2024
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| The facility shall encourage and assist each resident based on his or her individual preferences and needs to be clean and free of body and mouth odor. II
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11/4/2024
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| All medication shall be safely stored at proper temperature and shall be kept in a secured location behind at least one (1) locked door or cabinet. Medication shall be accessible only to persons authorized to administer medications. II/III
(B) Schedule II controlled substances shall be stored in locked compartments separate from non-controlled medications, except that single doses of Schedule II controlled substances may be controlled by a resident in compliance with the requirements for self-control of medication of this rule. II/III
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11/4/2024
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| The administrator shall develop and implement a safe and effective system of medication control and use, which assures that all residents ' medications are administered by personnel at least eighteen (18) years of age, in accordance with physicians ' instructions using acceptable nursing techniques. The facility shall employ a licensed nurse eight (8) hours per week for every thirty (30) residents to monitor each resident ' s condition and medication. Administration of medication shall mean delivering to a resident his or her
prescription medication either in the original pharmacy container, or for internal medication, removing an individual dose from the pharmacy container and placing it in a small cup container or liquid medium for the resident to remove from the container and self-administer. External prescription medication may be applied by facility personnel if the resident is unable to do so and the resident ' s physician so authorizes. All individuals who administer medication shall be trained in medication administration and, if not a physician or a licensed nurse, shall be a certified medication technician or level I medication aide. I/II
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11/4/2024
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| In addition to the orientation training required in section (62) of this rule any facility that provides care to any resident having Alzheimer ' s disease or related dementia shall provide orientation training regarding mentally confused residents such as those with Alzheimer ' s disease and related dementias as follows:
(C) For all employees involved in the care of persons with dementia, dementia-specific training shall be incorporated into ongoing in-service curricula. II/III
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11/4/2024
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Missouri Department of Health & Senior Services