Complaint Investigation Report

Based on documents reviewed, the facility received an order from Pine Park Health on 8/8/25, instructing the facility to discontinue Donepezil, start Olanzapine (2.5mg) every day, and increase dosage of Lexapro to 10mg. Based on the MAR reviewed, R1 was receiving Donepezil since admission until August 8, 2025 when Pine Park Health instructed the facility to discontinue. MAR reviewed showed Olanzapine (2.5mg) and Lexapro (10mg) was being administered as prescribed. On August 19, 2025, a new order was sent from Pine Park Health to discontinue the Olanzapine and Lexapro. LPA reviewed R1's current MAR and current prescribed medication list, centrally stored medication list was up to date.

Based on documents reviewed and information collected, the department has determined that although the above allegation may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are UNSUBSTANTIATED.

Report is reviewed with Administrator, Jennifer Duenas and a copy is provided.