Complaint Investigation Report

Staff interviews confirmed that the resident receives assistance with activities of daily living (ADLs), medication management, and intermittent home health services, all of which are allowable under RCFE regulations. Executive Director stated that the resident’s condition is regularly assessed and that any changes in condition are communicated to the physician and the responsible party. Additionally, there was no evidence that the resident had been denied access to appropriate medical care or that the facility failed to coordinate with outside providers when needed.

Observations during the visit showed the resident was alert, oriented, and participating in daily activities. There were no signs of neglect or unmet medical needs. The facility demonstrated compliance with Health and Safety regulations, which prohibits retention of residents who require care beyond the facility’s capabilities unless appropriate waivers or support services are in place.

On 2/26/25, it was alleged that the staff does not ensure that residents' confidential information is safeguarded. During the investigation, staff interviews confirmed that all employees receive training on confidentiality and resident rights upon hire and annually thereafter. Staff demonstrated knowledge of procedures for handling and storing resident records in compliance with regulations which requires that resident records be kept confidential and stored in a manner that ensures privacy. Observations during the facility visit confirmed that resident files are stored in a locked cabinet in a secure office area accessible only to authorized personnel. No records were observed left unattended or in public view. Medication Administration Records (MARs), physician orders, and care plans were reviewed and found to be properly maintained and secured. Staff were observed logging out of electronic systems when not in use, and no breaches of confidentiality were identified during the visit.

Additionally, there were no complaints or incident reports on file indicating that any resident’s personal or medical information had been disclosed inappropriately. The facility’s practices are consistent with Health and Safety regulations, which requires that facilities protect the confidentiality of resident records and only release information to authorized individuals.