The following conduct, acts, or omissions, when not resulting in death or serious physical harm to a resident, or the substantial probability thereof, but creates a condition or occurrence relating to the operation and maintenance of a long-term care facility which directly threatens the health, safety, or welfare of a resident:

1. (1)

   1. (A) Nursing techniques.

   2. (B) One thousand (1,000) points shall be assigned when:

      1. (i) Medications or treatments are improperly administered or withheld by nursing personnel;
      2. (ii) There is a failure to feed residents who are unable to feed themselves;
      3. (iii) There is a failure to change or irrigate catheters as ordered by a physician or use irrigation sets and solutions which are outdated or not protected from contamination;
      4. (iv) There is a failure to obtain physician orders for the use, type, and duration of restraints, or the improper application of a physical restraint, or failure of facility personnel to check and release the restraint as specified in rules;
      5. (v) Staff knowingly fails to answer call lights;
      6. (vi) There is a failure to turn or reposition residents as ordered by a physician or as specified in rule; and
      7. (vii) There is a failure to provide rehabilitative nursing as ordered by a physician or as specified in rule;

2. (2)

   1. (A) Poisonous substances.

   2. (B) Seven hundred and fifty (750) points shall be assigned when:

      1. (i) a facility fails to provide proper storage of poisonous substances; and
      2. (ii) This failure threatens the health, safety, or welfare of a resident;

3. (3)

   1. (A) Falls by residents.

   2. (B) Seven hundred and fifty (750) points shall be assigned when:

      1. (i) A facility fails to maintain required direct care staffing or a safe environment; and
      2. (ii) This failure directly threatens the health, safety, or welfare of a resident;

4. (4)

   1. (A) Assaults.
   2. (B) One thousand (1,000) points shall be assigned when a facility fails to maintain required direct care staffing or measures are not taken when it is known that a resident is combative and assaultive with other residents and these measures threaten the health, safety, or welfare of a resident;

5. (5)

   1. (A) Improper use of restraints.
   2. (B) One thousand (1,000) points shall be assigned when facility personnel apply physical restraints contrary to published rules or fail to check and release restraints as directed by physician's order or rules and such failure threatens the health, safety, or welfare of a resident;

6. (6)

   1. (A) Medical services.

   2. (B) One thousand (1,000) points shall be assigned when:

      1. (i) A facility fails to secure proper medical assistance or orders from a physician; and
      2. (ii) This failure threatens the health, safety, or welfare of a resident;

7. (7)

   1. (A) Decubitus ulcers.

   2. (B) One thousand (1,000) points shall be assigned when:

      1. (i) A facility does not take decubitus ulcer measures as ordered by the physician and such failure threatens the health, safety, or welfare of a resident; or
      2. (ii) Facility personnel fail to notify the physician of such ulcers and this failure threatens the health, safety, or welfare of a resident;

8. (8)

   1. (A) Treatments.

   2. (B) One thousand (1,000) points shall be assigned when:

      1. (i) Facility personnel perform treatments contrary to a physician's order; and
      2. (ii) Such treatment threatens the health, safety, or welfare of a resident;

9. (9)

   1. (A) Medications.

   2. (B) One thousand (1,000) points shall be assigned when facility personnel:

      1. (i) Withhold physician-ordered medication or medications from a resident and such withholding threatens the health, safety, or welfare of a resident; or
      2. (ii) Fail to order or stock medication or medications prescribed by the physician and this failure threatens the health, safety, or welfare of a resident;

10. (10)

    1. (A) Elopement.

    2. (B) One thousand (1,000) points shall be assigned when a facility does not provide:

       1. (i) Necessary supervision of residents to prevent a resident from wandering away from the facility and such failure threatens the health, safety, or welfare of a resident; or
       2. (ii) Adequate measures to ensure that residents with a history of elopement do not wander away from the facility and such failure threatens the health, safety, or welfare of a resident;

11. (11)

    1. (A) Food on hand.

    2. (B) One thousand (1,000) points shall be assigned when:

       1. (i) There is an insufficient amount of food on hand in the facility to meet the menus for the next twenty-four-hour period; and
       2. (ii) This failure threatens the health, safety, or welfare of a resident;

12. (12)

    1. (A) Nursing equipment/supplies.

    2. (B) One thousand (1,000) points shall be assigned if:

       1. (i) Equipment and supplies to care for a resident as ordered by a physician are not provided or if the facility does not have sufficient equipment and supplies for residents as specified by rule; and
       2. (ii) These conditions threaten the health, safety, or welfare of a resident or residents;

13. (13)

    1. (A) Falls.

    2. (B) Seven hundred and fifty (750) points shall be assigned when:

       1. (i) It is determined that falls occurred in a facility as a result of the facility's failure to maintain required direct care staffing or a safe environment as set forth in rule; and
       2. (ii) This failure threatens the health, safety, or welfare of a resident;

14. (14)

    1. (A) Call system.

    2. (B) One thousand (1,000) points shall be assigned when:

       1. (i) A facility fails to maintain a resident call system; or
       2. (ii) The call system is not functioning for a period of twenty-four (24) hours.

    3. (C) If call system cords are not kept within reach of residents:

       1. (i) Then it will be determined that the facility has failed to maintain a resident call system; and
       2. (ii) This failure threatens the health, safety, or welfare of a resident;

15. (15)

    1. (A) Heating and air conditioning.

    2. (B) One thousand (1,000) points shall be assigned when:

       1. (i) A facility fails to maintain its heating and air conditioning system as required by rule; and
       2. (ii) Such failure threatens the health, safety, or welfare of a resident.
    3. (C) Isolated incidents of breakdown or power failure shall not be considered a Class B violation under this section;

16. (16)

    1. (A) Dietary allowance.
    2. (B) Seven hundred and fifty (750) points shall be assigned when it is determined that the minimum dietary needs of a resident are not being met as ordered by the physician;

17. (17)

    1. (A) Resident rights.

    2. (B) Seven hundred fifty (750) points shall be assigned when facility personnel fail to:

       1. (i) Inform a resident of his or her resident rights as outlined in rule; or
       2. (ii) Allow a resident to honor or exercise any of his or her rights as outlined in rule or statute;

18. (18)

    1. (A) Sanitation.
    2. (B) Seven hundred and fifty (750) points shall be assigned when it is determined that rules relating to sanitation are not met;

19. (19)

    1. (A) Administrator.
    2. (B) Seven hundred fifty (750) points shall be assigned when it is determined that a facility does not have a licensed administrator as required by rule; and

20. (20)

    1. (A) Director of nurses.
    2. (B) Seven hundred and fifty (750) points shall be assigned when it is determined that a facility does not have a director of nursing as required by rule for five (5) or more consecutive days.