Complaint Investigation Report

Interviews with residents revealed the following 2 out of 6 residents have not move rooms, have not been requested, or requested to moved therefore do not know of the process. 2 out of 6 residents were not able to answer to questions due to cognitive skills. 1 out of 6 stated to have requested in writing to move rooms and move when a room was available and 1 out of 6 stated that a copy of notice was not provided when provided with the notice. Interviews with staff revealed 2 out 4 staff interviewed stated residents are notify prior to room change and if residents agree change happens. 2 out 4 staff stated that R1 was given a letter to notify of room change due to resident's changes in physical health. Administrator also stated resident was given a copy of 30 day on 3/15/22, however did not obtain a signature from R1 as a result on 4/5/22 provided another letter reinitiating the 30 days. Administrator stated R1 refuses to be assess by a physician to note change in physical condition and that the reason for the room is to ensure R1's safety as the cottage is licensed for non-ambulatory residents and staff have notice R1 becoming a fall risk and want to prevent further falls. LPA reviewed the following documents for R1's Admission agreement signed on 1/31/13. Appraisal Needs and Service Plan dated 2/23/22 notes resident refuses assistance and notes physical changes. Emergency and Identification Information form notes R1 is self-responsible. Letter to notify resident of room change dated 3/10/22 states change is due to changes in physical health and moved is to take place within a week. Second letter provided on 3/15/22 states the same reason and the move is planned for 4/15/22, (refer to complaint #28-AS-2022 0310140032 ). Third letter signed by R1 on 4/5/22 has updated move date to May 5th, 2022. LPA Flores advice administrator to ensure R1 is reassess by a primary physician and that facility contacts physician with current concerns, and changes in condition to ensure of proper assessment.

Although the allegations may have happened or are valid, there is not a preponderance of evidence standard to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED .

Exit interview was conducted with Peter Babaian Administrator and a copy of this report was provided.