Inspection Reports for
Paramount Parks at Eagle

.009.06.c Use of previous criminal history and background check: one of four employees required to have an Idaho State Police background check did not have the check completed prior to working alone with residents.

.215.01 Administrator responsibility: the administrator did not ensure all facility policies were implemented; staff conducting fire patrol had additional duties and resident room checks were not consistently done every thirty minutes as required.

.330.04.c.vii Resident care records: the facility nurse did not document pre-admission nursing assessments for ten sampled residents as required by IDAPA 16.03.22.011.20 and 16.03.22.305.

.404 Fire and life safety standards for existing buildings licensed for seventeen or more residents and multi-story buildings: the facility did not maintain compliance with NFPA 101 and related codes including lack of documentation for Alcohol Based Hand Rub dispenser inspections, self-closing doors being propped open, emergency plan staff training, suppression system gauge inspections, sprinkler pendants requiring replacement, and missing policy for elimination of ignition sources.

.250.12.j Resident sleeping rooms: the door to resident room #213 would not latch when fully closed.

.405.02.b Prohibited applications: a Relocatable Power Tap was plugged in succession to another creating a prohibited daisy chain in multiple areas.

.405.03 Medical gases: signage stating 'Oxygen in Use, No Smoking' was missing at four resident room doors where oxygen was in use; this is a repeat deficiency.

.155 Emergency preparedness requirements: the facility did not have a written emergency plan including each person's responsibilities and a point of assembly for drills as required by NFPA 101.

.155.01 Relocation agreements: the facility had only one relocation agreement instead of two and the agreement had not been updated annually, last reviewed in 2017.

.161.04 Designated smoking areas: the facility smoking policy did not specify designated smoking areas as required.

.250.10.b Heating, ventilation, and air-conditioning (HVAC): the natural gas fireplaces on the main floor and basement living areas were not equipped with safety barriers.

.335.03 Reporting of Individual with an Infectious Disease: the facility did not report individuals with an infectious disease to the local health district authority; Resident #2 tested positive for COVID-19 on 12/28/21 and Resident #3 on 1/3/22, but the facility delayed reporting until 3/1/2022.

.215.08.e. Corrective Action: the administrator did not ensure appropriate corrective actions were put into place to prevent recurrence of falls for residents, including inadequate interventions after multiple falls (previously cited 12/31/2014 and 12/29/2017).

.250.13. Secure Environment: the facility's memory care unit did not maintain a safe and secure environment as residents eloped through unlocked or malfunctioning gates.

.300.02. Licensed Nurse: the facility nurse did not assess residents after changes of condition, including wounds and symptoms such as nausea and diarrhea (previously cited 12/31/2014 and 12/29/2017).

.305.02.b. Current Medication Orders and Treatment Orders: residents did not receive medications and therapeutic diets as ordered, with multiple missed doses and lack of special diet recipes (previously cited 6/16/2017).

.310.04.e. Psychotropic or Behavior Modifying Medication: the facility did not include behavior updates on six-month psychotropic medication reviews for all sampled residents taking such medications.

.330.04. Resident Care Records: notebooks documenting unusual occurrences were not consistently incorporated into individual resident charts, and resident change of condition assessments were inconsistently documented.

.330.14. As Worked Schedules: the facility's as-worked schedule did not document dates and times the administrator was present, nor include staff first names or positions.

.451. MENU AND DIET PLANNING: the facility did not have a menu signed and dated by a registered dietitian, lacked standard portion sizes and therapeutic diet modifications, and did not document recipe modifications.

.415.04 Fire Alarm Smoke Detection System Service and Testing: no documentation for a 5-year sensitivity test of the smoke detectors.

.405.03 Medical Gases: no signage on the door of the oxygen transfilling room stating 'Oxygen Transfilling in Progress, No Smoking in the Immediate Area' and no secondary signage at resident room doors where oxygen is in use stating 'Oxygen in Use, No Smoking'.

.009.01 Criminal history and background check: one of ten employees reviewed did not have a Department criminal history and background check.

.225 Requirements for behavior management: resident #1 and #5's behaviors were not evaluated to develop behavior management plans to manage their behaviors, including yelling at staff and residents and refusal of cares.

.225.02 Intervention: the facility did not develop interventions for each behavior for residents #1 and #5, such as yelling at staff and residents and refusal of cares.

.260.04.a Insect and rodent control: the facility did not secure cleaning chemicals that were accessible to residents in the memory care kitchen.

.305.03 Resident health status: the facility nurse did not assess or document the condition of resident #7 and #9's wounds, including progression of wound status on resident #7's left heel and wounds on resident #9's coccyx and right shin.

.305.04 Recommendations: the facility nurse did not make recommendations regarding retention about resident #7's wound on her left heel to the administrator.

.320.01 Use of negotiated service agreement: NSA's were not updated to reflect the residents' specific needs, including wound presence and treatment, use of bed/chair alarms, oxygen, housekeeping/laundry needs, and diet implementation.

.711.01 Ongoing resident care records: the facility did not consistently document the time and dates of behaviors, what interventions were used, and the effectiveness of the interventions for residents #1 and #5.

.305.02.b. Current Medication Orders and Treatment Orders: residents were not assisted to take medications as ordered, including missing approximately six medications for Resident #1, lack of oxygen as ordered, and Resident #3 missing a medication for three days.

.600.05. Supervision: the facility administrator did not provide supervision to ensure residents received showers, cueing and assistance with eating, and diets as ordered; meal observations showed residents served food inconsistent with prescribed diets.

.405.03 Medical gases: oxygen transfill room was not properly signed, liquid oxygen was stored within five feet of combustibles, and a light switch by the liquid oxygen transfill/storage was within five feet of the floor.

.405.05 Structure, maintenance, equipment to assure safety: three open penetrations in the downstairs memory care mechanical room and elevator room ceiling access were removed; two broken filters were found at the kitchen hood; and a heat detector in the mechanical room was hanging and unsecured.