Incident investigation·December 11, 2023

On 12/11/2023 at 4:30PM Licensing Program Analyst (LPA) Lori Alexander arrived unannounced to conduct a Case Management visit to follow-up on a death report received by Community Care Licensing Division on 11/13/2023. LPA met with Executive Director (ED), Tracey Ingleman and explained the purpose of the visit. R1 passed away on 11/06/2023 with an unknown cause of death. Death report stated that R1 had an unwitnessed fall on 11/06/23 at 12:30PM. The death report revealed that R1 passed away at the hospital on 11/06/2023. During today's visit LPA requested additional information pertaining to R1's file which included: Physician's report (LIC602) Appraisal Needs and Services Plan LPA was informed by ED that R1's family will obtain a copy of R1's death certificate and during the visit the copy was received. The Certificate of Death reveals that cardiopulmonary arrest was the immediate cause of death of R1. No deficiencies cited during this visit. Exit interview conducted and a copy of this report provided.