Complaint Investigation Report

Record reviews and interviews further revealed that due to urgent care centers not open, facility staff arranged for and transported R1 to emergency room at a local hospital at approximately 11:15pm. Prior to leaving for the hospital, facility staff took a fourth blood pressure test for R1 which resulted in an additional high reading. It was further revealed through interviews and record reviews that staff was aware of R1’s history of high blood pressure. As a result of the time frame between the initial discovery of high blood pressure, the communication with the physician and actual time of R1 taken to emergency room by facility staff for treatment, it is determined that the preponderance of evidence standard is met, therefore , this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6 and noted on LIC 9099D. A civil penalty in the amount of $250 is issued in addition to citation due to repeat violation of Section 80078(a) within a 12-month period.

An exit interview was conducted with direct care supervisor and a copy of this report was provided. Appeal rights and LIC 811 provided.