Complaint Investigation Report

R1 Hospice Care Nurse Director shared that the hospice care team did not report any incident that the staffs at the facility are not assisting R1 out of bed. In addition, R1 Hospice Care Nurse Director reported that the hospice care team did not report any neglect by a staff at the facility to R1 or other residents. Also, R1 Hospice Care Nurse Director indicated that R1 skin's dry, fragile, and R1 does not have enough nutrition which makes R1 high risk and prone for skin breakdown at any time and not from poor care of the staffs at the facility. During the facility visit on 07/22/2024, 12/03/2024 and 12/17/2024, LPA Brown observed staff assisting their residents out of bed.

The second allegation indicates that staffs do not administer medications as prescribed. Interview with two (2) of two (2) residents indicated that staffs are giving their medications daily and administering their medications as prescribed by their physician. Two (2) of two (2) staffs interviewed reported that they are giving their residents medications per their doctor's order. Staff #1 (S1) reported to LPA Brown that there's no incident that happened at the facility that they placed two (2) medication patches on R1 and R1's family member cancelled the prescription. Interview with Hospice Care Nurse Director indicated that the hospice care team did not report staffs at the facility are not administering R1's medication as prescribed. During the facility visit on 07/22/2024, 12/03/2024 and 12/17/2024, LPA Brown noted that staffs at the facility are utilizing Medication Administration Record (MAR) to ensure that they are administering their residents medications as prescribed by their doctor. Moreover, LPA Brown audited two (2) residents medications on 12/03/2024 and observed that staffs at the facility are administering their residents medications as prescribed by their doctors.

The third allegation indicates that the facility does not provide adequate meals to meet residents needs. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interview with two (2) of two (2) residents indicated that the facility's providing them adequate meals to meet their needs and they can get second serving of food if they prefer. Two (2) of two (2) staffs interviewed reported that they are serving their residents adequate meals everyday and there's no incident that they did not provide adequate meals to their residents and they did not meet their needs. Two (2) staffs interviewed shared that they are providing adequate meals for R1. Hospice Care Nurse Director informed LPA Brown that the hospice care team did not report an incident that the facility's not providing adequate meals to R1 and not meeting R1's needs. During the facility visit on 07/22/2024, 12/03/2024 and 12/17/2024, LPA Brown observed that the facility's serving adequate and nutritious meals to their residents to meet their needs.

The fourth allegation indicates that staff scolded resident. Interview with two (2) of two (2) residents indicated ***Continuation in LIC9099C***