Inspection Reports for Shelby Comfort Care Assisted Living and Memory Care

The inspection was conducted in response to a complaint alleging that Resident A's care needs had not been met, including concerns about falls, staff inattentiveness, and medication management.

The investigation found that Resident A experienced seven documented falls within 30 days, with inconsistent implementation of interventions to prevent future falls and ensure safety. The facility failed to provide requested documentation related to medication administration and care. A violation was established regarding the failure to meet Resident A's care needs.

The complaint alleged that Resident A fell without a way to call for help, had ripped sheets, a clogged toilet for three days, staff sleeping on duty, missed medication updates, and poor staff responsiveness. The complaint was substantiated with evidence including photographs and interviews.

The investigation was initiated due to allegations of resident neglect and missing opioids from the medication cart at Shelby Comfort Care.

The investigation substantiated violations for neglect of residents, including inconsistent care and bruising, and for medication management failures, including missing controlled substances and incomplete narcotic count documentation.

The complaint alleged residents were neglected and opioids were missing from the medication cart. Both allegations were substantiated based on interviews, observations, and record reviews.

The investigation was initiated due to an anonymous complaint alleging that residents were not receiving appropriate care, including issues with wound care, bathing, falls, and medication administration.

The investigation found violations related to inadequate resident care, including failure to provide bathing assistance as indicated in service plans, failure to implement fall prevention interventions, and medications being administered outside the prescribed timeframes. Staffing levels were found adequate.

The complaint alleged that residents were falling, wound care was not maintained, some residents went 12-14 days without showers, and medications were administered late. The complaint also included allegations of inappropriate sexual behavior by a male resident, which was investigated separately and not included in this report. Violations were established for inadequate care and late medication administration; no violation was found for overnight staffing levels.

The investigation was initiated due to a complaint alleging that Resident A sexually assaulted Resident B in the facility's memory care unit.

The investigation confirmed that Resident A sexually assaulted Resident B, and the facility failed to protect Resident B from the abuse or implement interventions to prevent recurrence. Both residents remain in the memory care unit with some separation but without full protection.

The complaint alleged that Resident A sexually assaulted Resident B on 08/13/2024. The allegation was substantiated as a violation was established. APS referral was denied investigation. The facility provided incident reports, witness statements, and a police report confirming the incident.

The investigation was initiated due to an anonymous complaint alleging improper administration of resident medications, including missed doses and lack of communication among staff.

The investigation found that medications were not administered as ordered, with missed doses and late administration documented. The facility failed to report medication errors to the prescriber as required by policy, constituting violations of resident medication regulations.

Complaint was received on 2024-05-03 alleging that medications were not passed appropriately, with residents missing medications and poor communication among staff. The complaint was substantiated with violations established.

The inspection was conducted as a renewal inspection to evaluate compliance with licensing statutes and rules for Shelby Comfort Care.

The facility was found to be in substantial compliance with the public health code and administrative rules regulating home for the aged facilities. Renewal of the license is recommended.

The investigation was initiated due to a complaint alleging that a resident was not receiving required assistance, the facility entry was unsafe, the facility was not kept clean, and a family member was barred from visiting the resident.

The investigation found no violation regarding the resident not receiving assistance or the unsafe entry. However, violations were established for the facility not being kept clean and for barring a family member from visiting the resident. The facility was observed to have debris and trash on floors and furniture, and a family member was removed and banned due to disruptive behavior without evidence of offering controlled visitation.

The complaint alleged that the Resident of Concern (ROC) was not receiving assistance, the facility entry was unsafe, the facility was not kept clean, and a family member was barred from visiting. The investigation concluded violations were established for cleanliness and visitation restrictions, but not for assistance or entry safety.

The investigation was initiated due to a complaint alleging that the Resident of Concern (ROC) was not receiving appropriate assistance for personal care and that medication and medical testing were administered without notifying the ROC's wife.

The investigation found that the ROC was not receiving adequate assistance with activities of daily living such as dressing, bathing, and meal attendance, and the resident's service plan was not updated to reflect his true care needs. However, the allegation that medication and medical testing were administered without notifying the ROC's wife was not substantiated.

The complaint alleged that the ROC was not being provided appropriate assistance for personal care and that medication and medical testing were administered without notifying the ROC's wife. The first allegation was substantiated; the second was not.

The inspection was conducted as an original licensing study for Shelby Comfort Care following a change of ownership and application for a new license.

The facility was found to be in substantial compliance with applicable licensing statutes and administrative rules, with a few items initially out of compliance that were subsequently corrected through submitted documentation.