Complaint Investigation Report

LPA conducted a record review pertaining to Resident #1 during the review of records LPA discovered that Resident #1 was ambulatory and did not have any skin conditions. In addition, during the review of records LPA observed no records or reports stating that Resident #1 sustained pressure injuries.

Second allegation: Staff left resident on floor for an extended period of time. Regarding the allegation stated above, LPA conducted an interview with Resident #2 regarding the alleged allegation and Resident #2 informed LPA of being a witness when Resident #1 was lying on the bed and fell to the floor. Resident #2 informed LPA that resident waited for a while and then informed staff that Resident #1 was on the floor. Resident #2 informed LPA that staff immediately responded to Resident #1 and contacted 911. Resident #2 could not confirm the time that Resident #1 was on the floor but indicated that it was daytime. LPA conducted interviews with Staff #1-3 and all denied the alleged allegation and indicated that on 1/18/2025 at approximately 1:20PM Resident#2 informed staff that Resident #1 was on the floor unresponsive. Furthermore, Staff #1-3 informed LPA that Fire Department was contacted and transported Resident #1 to local hospital to be treated. Staff #1-3 informed LPA that on 1/21/2025 it was confirmed that Resident #1 had suffered a stroke. Based on corroborating evidence LPA has determined that the above allegations are Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Linda Woofter.