Facility Evaluation Report

On 1/14/26, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit and met with caregiver S1. Administrator arrived to assist as well

The purpose of the visit was to review and discuss the decline and passing of R1 that occurred on 12/26/25 as well as to discuss the procedure being considered by licensee for resident care plan documentation.

Records and interviews showed that R1 was experiencing physical decline and reduced intake. Appropriate communication occurred between facility staff, medical providers and emergency responders. Following a holiday home visit, R1 showed continued decline for which emergency care was provided. R1 passed away in hospital on 12/26/25 of natural causes. Issues discussed included documentation of resident change of status, physician contact and written medical guidance as well as retention and understanding of the terms of a resident POA agreement.

LPA, Admin also discussed resident appraisal and plans of care requirements for whoever the licensee designates for the task.

As a result of today’s inspection, no deficiencies were noted.

Report reviewed. Copy of report provided.