complaint·October 28, 2025

Continued from LIC9099 Staff did not seek timely medical attention for resident after a change in condition During interviews and record review, it was revealed the facility contacted W1 to schedule a doctor appointment for R1, due to changes in condition observed observe by S2. Interviews revealed W1 stated she couldn’t schedule R1 an appointment due to R1 not having a doctor here in this area and the appointments were booked out for 6 months. Staff do not ensure that resident call buttons are in proper working condition During interviews, it was revealed that R1 pressed call button on June 5, 2025, and S3 responded timely. During interviews it was stated R1 pulled her pull cord and S3 arrived shortly and found R1 on the floor expressing suicidal intent. Record review revealed pull cord in R1’s bathroom was pulled at 5:16am and S3 arrived at 5:22am . Licensee did not abide by the terms and conditions of resident's admission agreement During interviews and record review, it was revealed that the facility did abide by the terms and conditions of R1’s admission agreement. Interviews revealed that the facility did abide by the terms of R1’s admission agreement, and that R1’s condition changes which resulted in a fee adjustment for R1’s care needs. Record review revealed, facility conducted another evaluation of the R1 and proposed an increase in fees to W1 due to an increase in care needs for R1 Continue on LIC9099C... Continued from LIC9099C Staff are not dispensing medications as prescribed. During interviews and record review, it was revealed that staff followed R1’s physician report regrading administering medications. Interviews revealed that S2 followed R1’s new Physician report (LIC602), dispensed the medications listed on LIC602 and informed W1 of the change in medications. Record review revealed that R1’s physician made adjustments to R1’s medications that was previously prescribed . Based upon the information obtained during investigation. The above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and a copy of report was given to Lydia Hertzler.