Facility Evaluation Report

Licensing Program Bruce Jacobs conducted a case management visit at the facility to issue deficiencies relating to an incident report not submitted to the Department. LPA met with Facility Manager Julia Fragoso and the purpose of the visit was disclosed. On August 12, 2021, Licensing Program manager Liza King conducted a phone call the Administrator. During that phone call, information was obtained that the facility had a resident (R-1) who had tested positive for an infectious disease while hospitalized. Upon further review, the facility did not submit an incident report as required. In addition, it was determined that the facility did not conduct the required testing of staff of staff per Provider Information Notice (PIN) 21.32 or PIN 21.32.1 for surveillance testing or response testing after received a positive test result, per standard guidance as well.

Case management deficiencies are being issued on the following 809Ds. Appeal rights provided and exit interview conducted.