Facility Evaluation Report

On 11-02-23 at 3:00 pm, Licensing Program Analysts (LPAs) Renee Campbell arrived unannounced to conduct a case management visit regarding an incident which occurred on 10/03/23. LPA Campbell met with Administrator Renee Little and explained the purpose of the visit. LPA requested facility file documentation including physician's report for resident 1 (R1) and hospital discharge paperwork for R1. LPA also conducted facility observation and reviewed incident report dated 10-04-23. Additionally, LPA conducted brief interview with Administrator.

Based on incident report and interviews, the following was determined: R1 was taken to the hospital on 09/01/23 and evaluated. Based on discharge paperwork reviewed, R1 had contracted pneumonia and received antibiotics for treatment. R1 went to the hospital again due to a pressure wound on 10/03/23 and passed away that afternoon at approximately 4:42 pm. Per the death certificate, R1’s death was due to sepsis and pneumonia was listed as a contributing factor.

As a result of this case management, no citations are issued today. An exit interview was conducted with Renee Little and a copy of this report was provided to Renee Little.