Inspection Reports for
Life Care Center of Paradise Valley

Investigation of complaints 00133411, 00132731, 00132780 was conducted on June 19, 2025. Two deficiencies were cited related to infection control and administrative policies.

The facility failed to ensure that mechanical lifts were cleaned and disinfected according to professional standards after resident use, which could result in the spread of infection and resident illness. Observations and interviews confirmed that staff did not clean the lifts or slings after use, contrary to facility policy and manufacturer instructions.

Onsite complaint survey on August 26, 2024 of intake #AZ00214889 and AZ00214788. One deficiency cited related to abuse prevention.

The complaint investigation found that resident #77 was verbally and physically abused by a family member, including being slapped and called derogatory names. The abuse was substantiated by staff and resident interviews. The family member was prohibited from visiting the resident.

The facility failed to ensure resident #77 was free from verbal and physical abuse by a family member, resulting in emotional trauma. Interviews with staff and the resident confirmed the abuse, and the family member was subsequently barred from visiting.

Recertification survey for Medicare under Life Safety Code 2012 conducted August 7, 2024. Three deficiencies cited related to emergency preparedness drills, fire drills, and electrical systems maintenance.

The complaint involved a visitor of resident #392 yelling and cursing at resident #25, threatening to throw him out the window, and accusing him of inappropriate behavior. The visitor was removed from the unit and restricted to lobby visits. Resident #25 was placed on change of condition monitoring for three days following the incident.

The facility failed to ensure resident #25 was treated with dignity and respect by a visitor who yelled and cursed at the resident. The visitor was removed and restricted to lobby visits only. Additionally, the facility failed to ensure proper discharge planning for resident #49, resulting in delayed transfer due to uncoordinated DME and oxygen equipment arrangements. The facility also failed to ensure resident #49 did not have an empty oxygen tank while in use.

The complaint investigation was triggered by an incident on June 12, 2024, where a visitor yelled and cursed at resident #25, threatening to throw him out of a window, due to concerns about another resident's exposed clothing. The visitor was removed and restricted to lobby visits. The investigation included interviews with staff and residents, and review of policies. The visitor's behavior was unusual and not previously observed. Resident #25 was upset but denied inappropriate behavior.

The facility failed to ensure resident #25 was treated with dignity and respect by a visitor, failed to accurately reflect resident #3's advance directives in the medical record, failed to implement care plan interventions for monitoring medication side effects for resident #60, failed to revise care plans with resident-specific nutritional goals for resident #76, failed to ensure discharge planning met resident #49's needs including DME and transportation, failed to ensure resident #49 did not have an empty oxygen tank while in use, failed to ensure occupational therapist staff had valid CPR and first aid certifications, and failed to adequately monitor side effects related to psychotropic medication for resident #60.

State compliance survey conducted July 15-18, 2024 with complaint investigation. Seventeen deficiencies cited related to resident rights, care plans, abuse prevention, respiratory care, and personnel records.

The complaint investigation found substantiated verbal abuse incidents between residents #10 and #17, including verbal threats and aggressive language. Resident #17 expressed intent to harm resident #10 and was sent for psychiatric evaluation. Staff interviews confirmed awareness and interventions to prevent further incidents.

The facility failed to ensure that two residents were free from verbal abuse, with documented incidents of verbal aggression and threatening behavior between residents #10 and #17 on 3/27/2024. Staff intervened to separate the residents and arranged for psychiatric evaluation for resident #17.

Investigation of multiple complaints conducted June 10-14, 2024. Two deficiencies cited related to freedom from abuse and neglect.

The facility failed to ensure one resident (#8) was free from verbal abuse by a staff member, resulting in minimal harm or potential for actual harm. The staff member involved was terminated following the investigation, and the facility updated the resident's care plan to address behavior issues.

Complaint survey conducted May 15-16, 2024 for multiple intakes. Two deficiencies cited related to abuse prevention and infection control.

The complaint investigation found substantiated issues including failure to notify family of change in condition, resident-to-resident abuse, inadequate care plan updates, fall prevention failures, and infection control deficiencies.

The facility failed to notify family of a resident's change in condition, failed to prevent resident-to-resident abuse, did not update care plans after incidents, failed to implement fall prevention measures such as floor mats, and did not follow infection control protocols including use of enhanced barrier precautions and signage.

Onsite complaint survey conducted February 12-14, 2024 investigating multiple complaints. Nine deficiencies cited related to notification of changes, abuse prevention, care plans, accident prevention, infection control, and abuse.

A complaint was submitted by resident #1 on September 30, 2018 at 5:50 p.m. regarding medical record retention.

The facility failed to retain medical records for resident #1 as required by State law, destroying records before the mandated six-year retention period. The facility transitioned to Electronic Medical Records in 2019 and used offsite storage for records, with records older than six years destroyed.

Complaint was submitted by resident #1 on September 30, 2018 at 5:50 p.m. The complaint was related to the failure to retain medical records as required by State law.

The facility failed to ensure that medical records for one resident were retained for the required six years after discharge, as the records had been destroyed prematurely. The facility transitioned to Electronic Medical Records in 2019 and used offsite storage, but did not retain records older than six years.

The complaint investigation substantiated verbal abuse by a CNA towards resident #91 and identified medication misappropriation issues affecting 10 residents. Attempts to interview the CNA were unsuccessful. The facility lacked auditing procedures to detect medication misappropriation.

The facility failed to protect one resident (#91) from verbal abuse by a certified nursing assistant and failed to ensure that physician-ordered medications were properly administered to 10 residents, resulting in potential medication misappropriation. The facility lacked policies and procedures to audit medication records against administration records.

The complaint involved allegations of verbal abuse by a CNA (staff #14) towards resident #54, including cursing and rough handling. Additional allegations involved verbal abuse by another CNA (staff #33) towards resident #43, which was not properly reported or investigated by the facility. The facility failed to suspend or discipline the alleged perpetrators appropriately and did not report the abuse to the State Agency. Multiple interviews with residents, staff, and administrators confirmed these issues.

The facility failed to ensure residents were free from verbal abuse by staff, failed to implement abuse reporting and investigation policies properly, failed to timely report abuse allegations to the State Agency, and failed to maintain mechanical lifts in safe operating condition. Several residents reported verbal abuse incidents involving specific CNAs, and the facility did not take appropriate disciplinary or reporting actions. Mechanical lifts had maintenance issues and overdue service dates.

The facility had multiple deficiencies including failure to respect resident privacy, inadequate informed consent for psychotropic medication, lack of resident rights notification, inaccurate advance directives documentation, poor maintenance of resident rooms, verbal abuse by staff, failure to report and investigate abuse allegations, failure to notify Ombudsman of resident transfer, incomplete PASARR referrals, unqualified activities director and social worker, inadequate pressure ulcer care, catheter care deficiencies, lack of behavior monitoring for psychotropic medication, medication errors, unsecured medications, infection control lapses during continence care, and unsafe mechanical lifts.

The complaint investigation centered on an incident on 6/2/23 where Resident #9 was manually transferred due to dead batteries on mechanical lifts, resulting in a fracture. The CNA involved was suspended. An internal investigation concluded the injury was not due to neglect or abuse but acknowledged the resident's high risk for injury.

The facility failed to provide necessary services to Resident #9 to avoid physical harm, resulting in a major injury (femoral fracture). Staff transferred the resident manually despite orders to use mechanical lifts, which were unavailable due to dead batteries. An internal investigation found no evidence of neglect or abuse, but the resident was at high risk due to pre-existing conditions. Staff training and lift maintenance issues were noted.