Complaint Investigation Report

3 out of 7 residents who stated that they had a fall and staff responded right away and paramedics were also here quickly. 4 residents had not had a fall or seen anyone have a fall.

Staff interviewed stated that Resident R1 had an assist to ground and not falls.

Stated that 2 caregivers were needed and only 1 time there was a slight fall when 2 caregivers were providing assistance in a sit to stand chair and Resident R1 caught her feet under the chair and slid back and hit her head and had slight abrasion on right hip.

Administrator documented specific dates in which assist to ground was done during transfer:

01/07/24- Resident R1 fell to knees with no injury.

07/02/24- With staff and slipped from shower chair

07/21/24- Transfer with 2 staff with foot stuck under the chair causing Resident R1 to slide to to the floor.

Administrator stated that staff were always assisting Resident R1 with transfers and that they were not falls. Stated that they were assist to ground.

Documentation from the primary care doctor reveals that Resident R1 was seen on 1/4/24, 1/11/24,1/18/24,2/1/24,2/8/24, 2/15/24, 2/22/24, 3/4/24, 319/24,6/7/24

6/14/24, 6/21/24, 6/28/24, 7/5/24, 7/12/24 and 7/19/24.

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

In regards to the allegation Staff performed an unsafe transfer resulting in resident sustaining an injury, based on interviews conducted and information gathered it was revealed that 3 of 7 residents had needed a transfer and stated that staff did a good job. 4 residents stated that the staff are never neglectful.

Staff stated that Resident R1 needed assistance by 2 caregivers and only had 1 incident in which Resident R1 caught her feet under the chair and slid back and hit her head and had slight abrasion on right hip.

Stated Resident R1 was never neglected and the facility responded right away sending Resident R1 to the hospital.

Documentation from the primary care doctor reveals that Resident R1 was seen on 1/4/24, 1/11/24,1/18/24,2/1/24,2/8/24, 2/15/24, 2/22/24, 3/4/24, 319/24,6/7/24

6/14/24, 6/21/24, 6/28/24, 7/5/24, 7/12/24 and 7/19/24.

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