Apache Junction Health Center

In the surveyor’s words

From the most serious findings on record at Apache Junction Health Center, in the surveyor’s own words.

• Actual harm, isolatedF600Sep 14, 2023

  Based on clinical record review, staff interviews, and facility documentation, policies and procedures, the facility failed to ensure that one resident (#5) was free from neglect by failing to ensure oxygen was administered when needed and the provider was notified of decreased oxygen saturation. The deficient practice resulted in cardiopulmonary arrest and hospitalization for resident #5. Findings include: Resident #5 was admitted on [DATE] with diagnoses of multiple sclerosis (MS), epilepsy, and hypertension. The care plan dated [DATE] revealed the resident was admitted due to decreased activities of daily living (ADLs) ability related to MS exacerbation/flare with seizure disorder. […]

• No harm, potential for more than minimal, patternF842Feb 21, 2025

  Based on clinical record review, resident and staff interviews, and policy review, the facility failed to ensure that an incident involving staff to resident abuse was documented completely in the clinical record for 1 of 4 sampled residents (#2), and that medical records were maintained for the regulated timeframe for 3 out of 4 residents (#450, #451, #16). The deficient practice could result in incomplete documentation in resident medical records. Findings Include: -Regarding Resident #2 Resident #2 was admitted to the facility on [DATE] with diagnoses that included hypertension, multiple sclerosis, anxiety disorder, and paraplegia. […]

• No harm, potential for more than minimal, patternF600Jul 13, 2023

  Based on clinical record reviews, staff and resident interviews, facility documentation, review of policies, procedures, and police investigation report, the facility failed to ensure two residents (#1 and #2) were free from staff sexual abuse. The deficient practice could result in abuse of other residents at the facility. Findings include: Review of a facility document titled, Associate Disciplinary Action dated January 24, 2020 revealed that a resident complained that staff #100 made her feel uncomfortable when he hugged and kissed her on the cheek. […]

• No harm, potential for more than minimal, patternF755Jun 16, 2023

  Based on observations, staff interviews, and review of policy, the facility failed to ensure that an account of all controlled drugs was maintained and reconciled. The deficient practice could result in misappropriation of residents' medications. Findings include: During an observation conducted on June 14, 2023 at 10:53 AM with a Licensed Practical Nurse (LPN/staff #6), of the Station B medication cart. Review of the Controlled Substance Card Inventory form revealed that two cards had been added to the cart, but did not have a two-nurse reconciliation. She stated that both nurses would initial the form that the reconciliation had been completed. During an observation conducted on June 14, 2023 at 11:07 AM with a Licensed Practical Nurse (LPN/staff #33), of the Station C medication cart. […]

• No harm, potential for more than minimal, isolatedF600Feb 21, 2025

  Based on clinical record review, resident and staff interviews, and policy review, the facility failed to ensure one of 2 sampled residents (#2) were not verbally abused by a Licensed Practical Nurse (LPN/Staff#207). The deficient practice could result in residents being emotionally harmed. Findings include: Resident #2 was admitted to the facility on [DATE] with diagnoses that included hypertension, multiple sclerosis, anxiety disorder, and paraplegia. There was no evidence in the clinical record that the care plan had been updated regarding an allegation of abuse that occurred on November 19, 2022. A Quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score of 15, which indicated intact cognition. […]