Facility Evaluation Report

While at the facility reviewing records for the annual inspection, LPA observed Resident 4 (R4) discharge papers dated 7/3/23 indicates R4 developed pressure injury of sacral region stage 3, on 7/16/23 R4 developed decubitus ulcer of sacral region, stage 3 and pressure injury of left perineal ischial region, stage 3 and 1/22/24 indicate R4 with Pressure injury of sacral region, stage 3. R4 is currently in the hospital. The Administrator states there is no home health nurse following up on R4 as of this time.

Based on interview conducted by LPA with the Home Health nurse who provided care to R4 in July, R4 was admitted to home health for treatment of stage 3 wound on 7/4/2023 and got discharged on 8/25/23 because the wound healed.

A $500.00 immediate civil penalty is assessed on this day. Civil penalty determination related to serious bodily injury is pending.

Exit interview was conducted with the Administrator. Appeal Rights was provided.