Complaint Investigation Report

It was alleged that facility did not allow residents responsible person to select their own physician. It was reported that facility did not allow Resident #1’s (R1’s) family to speak to any doctors and ignored R1’s HMO group plan that was used when R1 was admitted. Interviews with the Administrator revealed that they ‘introduced’ R1’s family to their current Primary Care Physician (PCP), and the family ‘agreed’ to switch doctors. Additionally, R1’s first appointment with the new PCP was on 6/16/2021, and since then became R1’s PCP. Furthermore, interviews with random resident family members revealed that facility never spoke to them about any other doctor as they had their own up on admitting their family member to the facility. However, interviews with other random resident family members revealed that facility recommended a doctor when arriving at the facility, but they ‘never felt obligated’ to choose a specific PCP for their family members. Although facility recommends a PCP upon admittance, it is not a requirement for the family members to switch PCP. Based on interviews, the Department does not have sufficient evidence to support the allegation of “facility did not allow residents responsible person to select their own Physician”. Therefore, the allegation is deemed Unsubstantiated at this time.

Also alleged was facility is not following their visiting policy. It was reported that facility only allowed R1’s family members to visit on Sunday’s. Review of records revealed that facility had implemented a visitation plan which stated, ‘visitors to be scheduled in advance’, ‘be subject to staff availability’, and ‘a limitation to the number of visitors to enter at any one time’. On 08/27/2021, the Department sent out a Provider Information Notice (PIN) Summary 21-17.2-ASC to all licensed facilities with best practices for visitation which stated, ‘limit the number of visitors on the facility premises at any one time to avoid having large groups congregate’. Per Administrator interviews, they try to create a schedule so there aren’t overlapping visits or too many families visiting at the same time. Administrator stated to suggesting Sunday’s from 11am – 1pm as the set date and time for R1’s family to visit R1. Interviews conducted revealed that R1’s family members were asked not to come unannounced and it was better to schedule in advance. Interviews with random family members revealed that earlier in the pandemic, they had to call ahead to make sure it was okay to come visit. Although family members were asked to call ahead and schedule, there were no concerns in doing so afterwards as a family member stated, ‘we usually send a text message giving them a heads up that we are on our way’. Based on interviews and record review, the Department does not have sufficient evidence to support the allegation of “facility is not following their visiting policy”. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No citations issued. A copy of report provided via email.