Complaint Investigation Report

Regarding the allegation Staff left resident in soiled diapers for an extended period.

The Reporting Party alleged that Resident 1 was found soiled. During interview, Resident 1 stated that they are independent with toileting and does not require staff assistance. Resident 1 denied concerns regarding personal care. Staff 1 stated that residents who use incontinence products are generally independent with changing themselves and that staff and facility care staff provide assistance when needed. LPA reviewed the resident’s LIC 602A, which reflects that the resident is able to care for own toileting needs. 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.

Regarding the allegation Staff are mismanaging residents' medications. The Reporting Party alleged that medications were being administered approximately one hour early and that certain medications requiring administration with meals were not always being given according to instructions. During the investigation, LPA interviewed the Reporting Party and reviewed the resident’s Medication Administration Record (MAR) and Centrally Stored Medication Record. LPA also interviewed facility staff regarding medication administration. The investigation did not reveal sufficient evidence that the resident’s medications were being administered incorrectly. Review of the MAR and medication records did not document evidence supporting the allegation that medications were being mismanaged. Although the Reporting Party expressed concerns regarding the timing of medication administration, the investigation did not produce sufficient evidence to establish that medications were administered in a manner that was inconsistent with physician orders or that the resident experienced harm as a result of the alleged timing medications. 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.

Exit interview conducted with Facility staff, Jose Vitan, and copy of report provided