Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of documenting a deficiency observed during the initial investigation visit for complaint reference 22-AS-20230327134042. LPA was greeted and granted entry by caregiving staff who notified administrator of the visit via telephone. Administrator arrived later to assist with the visit.

During the visit, LPA requested, obtained and reviewed resident records for all six residents present. Records kept at the facility were found to be incomplete in multiple instances. There is no medical assessment on file for resident R1. Resident was admitted from a Skilled Nursing Facility with a hospice service already providing care but the physician report was requested but never obtained.

Signed admission agreements are missing from the records maintained at the facility for resident R2 and R3.

Individual Needs and Services Plan and Resident Assessments are also absent from the records maintained at the facility for residents R2, R4 and R5.

A type B citation is being issued for this deficiency.

An exit interview was provided and a copy of this report along with appeal rights was provided and left at the facility.