AHCA Letter Dated: December 16
To: Claudine Alexander-Leger, Administrator
Sun City Retirement Residence
3855 Upper Creek Drive
Ruskin, Fl 33573
Dear Ms. Alexander-Leger:
This letter confirms the findings of a complaint investigation (CCR#2008013052) conducted on December 5, by Patric Halbert, HFEII, and Sharon McCrary, HFEII.
The allegations regarding dietary, rodents/insects, and lack of assessment were not confirmed.
Further, it was alleged that there issues regarding resident care, untrained/unqualified staff, resident rights, and the environment. These allegations were CONFIRMED and have been cited on the attached AHCA Form 3020 (Statement of Deficiencies and Plan of Correction). Please provide a plan of correction and return the original copy to this office within ten (10) calendar days of receipt.
Documents relating to State Licensure will be made available for public disclosure as required by the Florida Statutes.
The Quality Assurance Questionnaire has long been employed to obtain your feedback following survey activity. This form has been placed on the Agency's website at www.fdhc. State. Fl.Us/Publications, as a first step in providing a web-based interactive consumer satisfaction survey system. You may access the questionnaire through the link under Forms on this page. Your feedback is encouraed and valued, as our goal is to ensure the professional and consistent application of the survey process.
If there are any questions concerning this report, please contact Ms. McCrary, of this office at (727) 552-1133.
Sincerely,
Kathleen Vargan
Patricia Reid Caufman
Field Office Manager
Page 1 Admission Criteria Standards: This STANDARD is not met as evidenced by: Based on record review, observation, and staff interview, the facility failed to ensure that residents sampled did not require 24-hour nursing supervision.
Findings include: Observation of the resident during tour on 12/05/08 at around 4:30PM revealed a frail looking resident laying in a hospital bed with an air mattress and 1/2 side rails, she did not respond except to follow with eyes.
ADMISSIONS CRITERIA STANDARDS: The physical and mental status of the resident, including the identification of any health-related problems and functional limitations.
*This section of the report is from page 1-4, see report for more details.
Page 5 STAFFING STANDARDS Staff who provide care to residents, who have not taken the core training program, shall receive a minimum of 1 hour in-service training within 30 days of employment that covers the following subjects: Resident rights; Recognition of abuse, neglect and exploitation and making reports.
Observation by AHCA: This STANDARD is not met as evidenced by review of 11 sampled personnel records on 12/5/08. Two staff members with employment over 30 days had not received such training.
Page 6 STAFFING STANDARDS Staff who provide direct care to resident, other than nurses, CNA's, or home health aides trained in accordance with rule 59A-8.0095, must receive three hours of in-service training within 30 days of employment that covers the following subjects:
1. Resident's behavior and needs.
2. Providing assistance with activities of daily living.
Observation by AHCA: This STANDARD is not met as evidenced by:...
Review further information on pages 4-7.
Page 7 Observation by AHCA: Based upon interviews with staff and family members as well as random observation on 12/5/08, the facility failed to provide sufficient staffing to meet the needs of 31 residents in the secure area of the facility.
Initially upon entering the unit, 1 staff person was visible in the large common area. Observed at this time were about 20 residents sitting in the common area. Residents were not involved in any activity and there was no consistent staff interaction. Some appeared to be resting with eyes closed, others just staring into space. Others were observed wandering. Two female residents walked in from the patio area arm & arm, 1 of these residents was in bare feet. One resident was observed sitting in an armchair with a clothing protector already on. The clothing protector (bib) was dingy looking and somewhat frayed.
Residents in the dining area at 5:30PM, were observed attempting to drink beverages using spoons. A resident was observed walking around in the staff office and medication room while staff were out of the room.
A female walked into the dining area without pants on. One resident was observed feeding another resident with the same spoon she was eating from. The resident who was feeding the other resident was not eating her own meal. Several other residents were not eating and were playing with their food or their neighbors food. One female resident asked the surveyor for help stating "Ma'am, I need someone to help eat". A family member who was seated at a table with her father, was helping another female resident at the same table with her meal.
At 6:30PM, the surveyor ovserved some of the residents were still playing with their food, meal time assistance not provided due to staff attempting to intervene and re-direct those residents they could. Given the level of assistance the 31 residents in this secure area needed, it was impossible for the 3-4 staff available to provide the care required and ensure residents receive meal time assistance.
In conclusion, it was obvious that the staff available were not able to provide the level of care needed for these residents in the Memory Care unit. THIS LACK OF ASSISTANCE WITH EATING puts residents' health AT RISK for unintended weight loss, malnutrition, and exposure to communicable illness.
Page 10 Observation by AHCA: STANDARD not met as evidenced by personnel records on 12/05/08 that 3 staff members as were reviewed out of 11 records, did not have current valid certification in CPR and 1st Aid. The review of the personnel record for the LPN did not contain proof of CPR certification.
Page 11 Observation by AHCA: STANDARD not met as evidenced by: Based upon staff interview, observation of the evening medication pass and a review of the prescribed medications and medication ovservation records, the facility did NOT ensure that medication observation records were maintained accurately for 1 out of 4 resident records reviewed.
In one record reviewed one patient was not given the medication as prescribed for a continual period of seven days over a 3-month period.
The report goes on in detail about a lack of interaction with the residents. The report states that the current activity program in place for the memory support/secure is NOT addressing the needs of the residents who reside there. Page 17
On page 19, the report finally goes into the PHYSCIAL PLANT STANDARDS
AHCA observation: This STANDARD is not met as evidenced by: Based on observation, the facility did not ensure that peeling paint or wallpaper, missing ceiling or floor tiles, or torn carpeting was repaired or replaced.
Findings include: The carpet in the secured unit dining room was badly stained (food stains and fecal-matter stains).
Page 20, Food handling standards-NOT met.
The facility did not ensure that documentation was available showing all staff who prepare or serve food must receive a minimum of 1-hour in-service training within 30 days of employment in safe food handling practices.
(AHCA) FINDINGS Include: Record review on 12/05/08 and an interview with the ADMINISTRATOR at 8:15PM determined that 8 of 11 current staff reviewed all emplyed over 30 days serve food and had not received a minimum of 1-hour in-service training within 30 days of employment in safe food handling practices. Page 21 of 21
*This report goes into much more detail than could possibly be displayed here. It is available for public review. As it is a public report by a State Agency than there should be validity to said report on this facility under the care of, at that time, the administrator Claudine Alexander Leger. Ms. Leger claims to have a lot of experience. Evidently, the report shows that she was not able to care for this facility as would have been best suited for the residents.
Witnesses have verified all information, as it stands.
(The elderly are vulnerable. Those that care for them, should enforce the standards that display a commitment of concern and educated attention to their needs. This report by the State of Florida, Department of AHCA lists in detail many areas that were clearly in need of improvement).
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