Facility Evaluation Report

Licensing Program Analyst (LPA) S Vaid conducted a case management visit for the death of Client #1 (C-1). LPA met with Administrator- Juliet Nsiimye and explained the purpose of the visit.

The facility submitted a death report for C-1 who passed away on 07/09/2026 at the hospital. According to the death report and interview with the Administrator, C1 was admitted due to low oxygen caused by pneumonia.

On 06/26/2026 C1 was transported by paramedics and admitted to Inter-Community Hospital due to low-oxygen, C1 was discharged from hospital 06/29/26. On 06/30/26, C1 was transported to Inter-Community for low oxygen caused by pneumonia. While at the hospital C1 experienced seizure like activity on 07/07/26. C1 was further admitted to ICU where C1 reportedly had cardiac arrest. and passed away on 07/09/2026. Facility was notified by C1’s family and reported to licensing on 07/10/2026.

LPA obtained copies of the following documents: Face sheet, Physician's Report/ Medical Record. MAR log for June and July 2026, functional capabilities, Serious Injury Report dated 06/26/2026, 06/30/26 and 07/10/2026. Palliative Medical consultation report.

LPA also requested for a copy of the death certificate when it becomes available.

An exit interview was conducted, and a copy of this report was provided to the Administrator Juliet Nsiimye.