Facility Evaluation Report

Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced Case Management Incident visit. LPA was greeted and granted entry by Administrator Christine Ross. The visit was in response to the death of Resident #1 (R1), who passed away on December 1, 2022.

During LPA's visit, LPA reviewed R1's file and obtained copies of the following: ID/emergency Information, admission agreement, Physician's reports, resident appraisal, appraisal needs and service plan, progress notes, and medication records (MAR) for November 1, 2022 - November 17, 2022. LPA also requested a copy of R1s death certificate when it is made available.

During today's visit no deficiencies were cited in regard to this incident.

An exit interview was conducted, and a copy of this report was provided along with a copy of the LIC811 (confidential names list).