Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
6400.164(b) | Individual #2's MAR was not always filled out immediately after each individual's dose of medication. The following errors were noted: 08/01-08/05/18 -- No signature for Latuda 80mg to be administered at bedtime. 09/05 -- No signature for Latuda 80mg to be administered at bedtime. 09/17 -- No signature for Hydrocortisone @ 9pm. 09/20 -- Missing signature for the 7am administration of Denta 5000. | The information specified in subsection (a) shall be logged immediately after each individual's dose of medication. | ¿ Program Specialist will retrain staff on following medication administration policy and guidelines by 1/31/2019. See Attached # 8
¿ Ongoing, Program Specialist will ensure staff understand and adhere to medication administration policies and guidelines. Program Specialist will address with staff if policy and guidelines are not followed. |
02/16/2019
| Implemented |
6400.167(b) | Individual #2's meds were not administered as directed. The following errors were noted: On 09/21 8pm Oyst Cal/ Vit D 500/200 was not given at 4pm. They called the nurse at 8pm, she said to hold off until the 9pm dosage since it was so close to being administered. On 11/02 -- Hydrocortisone 1% was not administered, but signed for. Finally, Individual #2's MAR states she is to get five drops of neo/poly ear drops 2x daily starting on 11/12 before a medical appointment. According to the MAR, it was not administered at 7am on 11/12 because were no neo/poly ear drops present at the house. | Prescription medications and injections shall be administered according to the directions specified by a licensed physician, certified nurse practitioner or licensed physician's assistant. | ¿ Program Specialist will retrain staff on following medication administration policy and guidelines by 1/31/2019. See Attached # 8
¿ Ongoing, Program Specialist will ensure staff understand and adhere to medication administration policies and guidelines. Program Specialist will address with staff if policy and guidelines are not followed. |
02/16/2019
| Implemented |
6400.181(e)(9) | On the section of Individual #2's assessment that deals with documenting the individual's disability, all that was written was "Mild IDD"···but the physical form listed many other conditions and diagnoses. | The assessment must include the following information: Documentation of the individual's disability, including functional and medical limitations. | ¿ Program Specialist completed individual¿s # 2 Assessment related to disability, including functional and medical limitations by 2/15/2019. See Attached # 6, page 2.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(10) | There was no lifetime medical history or any medical history at all listed in Individual #2's assessment. | The assessment must include the following information: A lifetime medical history. | ¿Program Specialist will attach a life time medical history to the Assessment for Individual #2 by 2/14/2019. See Attached # 7.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(12) | There were no recommendations made in Individual #2's file. | The assessment must include the following information: Recommendations for specific areas of training, programming and services. | ¿ Program Specialist completed individual¿s # 2 recommendations for specific areas of training, programming and services by 2/15/2019. See Attached # 6, page 42
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019 |
03/31/2019
| Implemented |
6400.181(e)(13)(i) | Individual #2's progress and growth in the last 365 days was not addressed in the area of health. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Health.
| ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 2-5
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(ii) | Individual #2's progress and growth in the last 365 days was not addressed in the area of motor and communication skills. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Motor and communication skills. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 6-8.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(iii) | Individual #2's progress and growth in the last 365 days was not addressed in the area of residential living. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Activities of residential living. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 8-12, 18-23.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(iv) | Individual #2's progress and growth in the last 365 days was not addressed in the area of personal adjustment. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Personal adjustment. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 5, page 35.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(v) | Individual #2's progress and growth in the last 365 days was not addressed in the area of socialization. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Socialization. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 34-35.
¿ Director of IDD Residential Services, Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(vi) | Individual #2's progress and growth in the last 365 days was not addressed in the area of recreation. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Recreation. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 34-35.
¿ Director of IDD Residential Services, Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(vii) | Individual #2's progress and growth in the last 365 days was not addressed in the area of financial independence. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Financial independence.
| ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached #6, page 30.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(viii) | Individual #2's progress and growth in the last 365 days was not addressed in the area of managing personal property. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Managing personal property. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 18-20.
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(e)(13)(ix) | Individual #2's progress and growth in the last 365 days was not addressed in the area of community integration. | The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Community-integration. | ¿ Program Specialist completed individual¿s # 2 for progress and growth by 2/15/2019. See Attached # 6, page 23-24, 42
¿ Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in requirements of The Assessment by 3/15/2019.
¿ All Assessments will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.181(f) | There is no documentation in Individual #2's file that would indicate the assessment was sent to the SC and team at least 30 days prior to the ISP meeting. | (f) The program specialist shall provide the assessment to the SC, as applicable, and plan team members at least 30 calendar days prior to an ISP meeting for the development, annual update and revision of the ISP under § § 2380.182, 2390.152, 6400.182 and 6500.152 (relating to development, annual update and revision of the ISP).
| Director of IDD Residential Services , Martha Gonzalez will assure Program Specialist are retrained in providing The Assessment to the SC and the plan team members at least 30 calendar days prior to an ISP meeting by 3/15/2019.
¿ All documentation of Assessment distribution will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |
6400.186(a) | Individual #2 had a late quarterly. They were completed on 03/22/18, 06/22/18, 07/19/18, then not again until 12/22/18. There was a five month gap between the July and December reviews. | The program specialist shall complete an ISP review of the services and expected outcomes in the ISP specific to the residential home licensed under this chapter with the individual every 3 months or more frequently if the individual's needs change which impacts the services as specified in the current ISP. | Director of IDD Residential Services, Martha Gonzalez will assure Program Specialist are retrained in requirements of The ISP and 3 month or more frequent review & documentation with signatures by 3/15/2019.
¿ All ISPs and 3 month or more frequent reviews will be reviewed and updated for accuracy by Program Specialist by 3/31/2019. |
03/31/2019
| Implemented |