Complaint Investigation Report

The investigation revealed of the following: In regard to the allegation of “Resident sustained an witnessed fall resulting in a broken bone.” All staff denied the allegation and reported staff found R1 was in a kneeling position in the side of the bed and R1 did not want to get up, staff gave R1 time and came back and saw R1 was on the floor scooting to the restroom. Staff also reported R1 often slept partially off the bed, so it was not particularly unusual to see R1 kneeling by the bed. R1 was also able to ambulate for a full day following when the staff found R1 kneeling by the bed and witnessed R1 scooting to the restroom.

Based on the interviews conducted with staff and residents and record review, Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the complaint investigation of the allegations are all UNSUBSTANTIATED.

An Exit Interview was conducted. The copy of the report and appeal right were provided to MSW Lynn Palin