Complaint Investigation Report

notice no bed sores of any kind on the residents. One family member understands that despite they wish their family member to use the bathroom independently, unfortunately the resident has to wear diapers, but they commend the staff for doing a wonderful job with the incontinence care and toileting assistance. One of the staff interviewed said they have a schedule they follow with the toileting and incontinence care. They assist, change and check residents for the toileting assistance and incontinence care in the morning, before lunch and before dinner. Nighttime shift staff check them before the daytime shift staff leaves. Sheila Ben, one of the administrators interviewed, said her staff are very hands on with the residents in toileting assistance. From her nursing background perspective, Administrator Ben said that patients would have wounds, and they would smell. For her and her other administrator Maria Avila it is unacceptable for the residents to have bad hygiene.

It was alleged that staff allow resident to be left in soiled clothing for extended periods of time. From LPA Tea’s observation during the initial investigation, residents were in clean clothes. Their beds and rooms were clean and odor free and there are no signs or evidence of residents in soiled clothing. Both residents that the LPA have spoken to said they never had soiled clothing or sat in soiled clothing. Four out four family members of residents interviewed have agreed that their family has always been presentable and dressed in clean clothing and never in soiled clothing. Two out of two staff interviewed have similarly stated that residents are clean and checked every so often. They change them every day. One staff member stated that they reposition their bed bound residents and apply lotions. Both ADs Ben and Avila stated their staff go above and beyond for the residents. AD Ben mentioned the hospice staff that come to the facility advocates for hygiene and gives them reminders.

It was alleged staff are using medication as a form of restraint on resident in care. LPA reviewed the physician’s orders for resident medications, and the facility has been following the doctor’s order. It is well documented in the MAR record and used in the recommended dosage. Staff would check with the administrator and the hospice for medications such as Lorazepam to calm the residents with dementia who have agitated behavior. One family member interviewed does have a family member who is a licensed pharmacist and goes over the medication dosage of the resident. Another family member interviewed regarding medication said they have a discussion with the doctors and the facility about the right dosage of medication given to their family member at the facility. They work and communicate with them and confirm they are not over medicating the resident, it is very transparent.

(Complaint Investigation report continued on LIC9099C)