Complaint Investigation Report

residents constantly and Administrator indicates an expectation of hourly checks. Resident interviewed confirmed staff are attentive to needs.

Regarding the allegation that staff do not follow resident's care plan, the investigation revealed the following: R1 is equipped with a glucose monitoring device. Staff indicate monitoring and inserting the device. Facility was cited on 05/08/2026 for having a non-skilled staff inserting the device. Staff state checking the blood sugar on the device app and advising hospice of the reading daily. LPA obtained documentation of the readings. Staff indicate family requested this process and LPA is unable to find any written order requesting the reading from hospice or a physician.

Regarding the allegation that staff do not ensure resident intakes adequate fluids, resulting in mild dehydration, the investigation revealed the following: Three out of three staff state water and fluids are offered to all residents. Facility staff cannot force a resident to drink but only encourage. LPA observed residents with water cups at meal time and staff encouraging hydration.

Regarding the allegation that staff do not meet resident's hygiene needs, the investigation revealed the following: Interview with hospice bath aide indicated resident has been receiving baths three times a week from hospice for a couple months. The bath aide stated that when the service commenced, the fungal infection was already being treated and has since cleared. Facility staff state baths were being given and the infection was reported and treated once it was discovered. Hospice narrative indicate the resident was treated with Nystatin for 14 days and the infection was resolved.

Due to conflicting information, LPA is unable to corroborate allegations. Therefore, the allegations are deemed unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided.