Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Parks arrived on Wednesday December 17, 2025 to follow-up on a death report that was received by the Department on December 16, 2025. LPA met with Shalon, Resident Services Director.

R1 had a unwitnessed fall on 12/9/2025. R1's POA found R1 around 8:30am, sitting on the floor with their arm between the bed and night stand. R1 complained of pain. Staff called 911 and resident was sent out for evaluation. At the hospital, R1 was diagnosed with sepsis of unknown origin and organ failure and passed on 12/12/2025.

R1 moved into the facility 9/29/2025. Upon move-in, staff assisted R1 with medication management, status checks, and psychosocial prompting. On 12/5/2025, Shalon reassessed resident and their current care plan included medication management and minimal status checks. R1 was independent with bathing, dressing, grooming, eating, and toileting. R1 did not have a diagnosis of cognitive impairment.

LPA obtained a copy of R1's physicians report and assessments (2). LPA requested a copy of R1's death report, when available.

Exit interview conducted. A copy of this report was provided to the facility.