Complaint Investigation Report

The LPA reviewed hospice notes dated from September 29, 2023, to February 27, 2024, and found that hospice nurses consistently educated caregivers and medical technicians during each visit to the facility. The topics covered included repositioning techniques, aspiration precautions, and R1's feeding position.

LPA interviewed two (2) hospice nurses who observed R1’s bruises. Both nurses confirmed the bruises were likely from someone’s hand, but neither nurse was able to tell what or who caused the bruises. Both nurses asked the facility caregivers about R1’s bruises at the time of the discovery, but none of the caregivers had any knowledge of events or incidents that could explain R1’s bruises.

Based on LPA’s record reviews and staff interviews, the investigation did not reveal corroborating evidence to determine the cause or source of R1’s bruises. Therefore, the allegation is determined to be Unsubstantiated . A finding of Unsubstantiated indicates that while the allegation may have occurred or been valid, there is not a preponderance of evidence to conclusively prove that the alleged violation took place.

An exit interview was conducted where a copy of this report was provided.