Arcadia Care Auburn

decision making of activities of daily living.R11's Care Plan with a revision date of 1/13/2025, documents, Resident has an actual skin impairment of (specify type: pressure/skin tear/bruise/surgical incision/rash/venous/stasis ulcer/arterial/ischemic ulcer/cellulitis/diabetic ulcer/) to (location). *Do not list stage* diabetes, diuretics, edema, fragile skin, impaired mobility, incontinence.

Avoid exposure to temperature extreme.On 8/13/2025 at 10:02 AM, R11's room registered 86 degrees Fahrenheit with 62% humidity = 102 degrees F (extreme caution). On 8/15/2025 at 1:11 PM, R11 stated, The AC did break, and it was so hot in here and I am so thankful it is fixed now.

They brought in some fans for my room, but it was just blowing around hot air, and it was not pleasant. It was so uncomfortable, and I felt so tired.R11's August 2025 Vital Documents for breathing 8/12/2025, and 8/19/2025. No other documentation was present for the month of August. No other documentation was present addressing vitals and or any resident assessment related to heat.On 8/13/2025 at 2:32 PM, V16, Medical Director stated, I would expect the residents' room temperatures to follow the policy and standards for the temperature guidelines. I know the AC is up and working now.

For this population extreme heat is not always good thing but sometimes there can be other things going on as well with the patient. I would expect fans to be placed in residents' rooms and attempts to lower the room temperatures made by the facility.

The Heat Emergency Policy with a revision date of 11/1/2024 documents, The purpose of this guideline is to provide precautionary and preventative measures for our residents during the hot and humid summer months.

Older adults are extremely vulnerable to heat related disorders.

Heat Exhaustion: A disorder resulting from overexposure to heat or to the sun.

Early symptoms are headache and a feeling of weakness and dizziness, usually accompanied by nausea and vomiting.

There may also be cramps in the muscles of the arms, legs, or abdomen.

The person turns pale and perspires profusely, skin is cool and moist, and pulse and breathing are rapid.

Body temperature remains at a normal level or slightly below or above.

The person may seem confused and may find it difficult to coordinate body movements.

Heat Stroke: A profound disturbance of the body's heat-regulating mechanism, caused by prolonged exposure to excessive heat, particularly when there is little or no circulation of air.

The first symptoms may be headache, dizziness and weakness.

Later symptoms are an extremely high fever and absence of perspiration.

Heat stroke may cause convulsions and sudden loss of consciousness. In extreme cases it may be fatal. If the heat in the building increases above state mandated guidelines evacuate if necessary and follow evacuation policy.The Facility Vital Signs Monitoring Policy with an effective date of 4/2025 documents, Definition includes temperatures, pulse, respirations, and blood pressure, May also include pain level and oxygen saturations.

Blood pressure 90/60 mm Hg to 120/80 mm Hg.

Breathing 12-18 breaths per minutes; Pulse 60-100 beats per minute.

Temperature 98.8 F to 99.1 F (36.5 C to 37.3 C/ average 98.6 F (37.0).

Vital signs may be obtained more frequently with change of condition.

Abnormal vital signs will be reported to the physician.The Immediate Jeopardy and deficiency practice that began on 8/7/2025 when the air conditioning was no longer working and the IJ was corrected/removed on 8/27/2025 after the facility took the following actions to correct the noncompliance prior to the start of current survey: AC unit was immediately repaired.

Facility purchased extra fans and portable AC unit.

Facility initiated Heat Emergency Policy making hourly rounds, offering water, wet rags, offering to relocate residents. R1, R2, R3 and R11 have been accessed and documented for risk of heat induced illness.

All staff was in-serviced on Heat Emergency Policy.

All nursing staff were in-serviced on documenting and monitoring resident's vitals and identify signs and symptoms of head induced illness.

Also offering to relocate residents while under a Heat Emergency.

All residents were assessed, and a QA (Quality Assurance) meeting was held to ensure compliance with facility Heat Emergency Policy.

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