Incident investigation·January 26, 2023

On 1/26/23 at 12:45 AM, Licensing Program Analyst (LPA) Malia Thao conducted a case management - incident inspection. LPA explained reason for inspection at reception desk and met with Administrator (ADM) Makaryan "Kristina" Hripsime. CCL received special incident reports (SIRs) from the facility for incidents that occurred on 11/29/22 and 12/4/22. On 11/29/22, the facility experienced a power outage at 6:15 PM and received an ETA of 9:30 PM for power to be restored, by the electric company. Three residents (R1, R2, R3) use oxygen concentrators. The oxygen concentrators were turned off due to the power outage. Facility had residents use their oxygen tanks. ADM advised that ADM knew the residents oxygen tanks would not last through the night, so ADM called for non-emergency ambulance, where R1, R2, and R3 were all taken to the hospital. R2 and R3 returned to the facility within 24 hours without issues. R1 was admitted to the hospital due to other medical issues. LPA reviewed records and interviewed ADM about the incident. Facility reported that on12/4/22, R1 was found on the floor. R1 uses full bed rails. Hospice was called for an assessment of R1. ADM advised facility staff did not observe any injuries to R1 prior to call to hospice. ADM stated R1 must have scooted R1's self to the end of the rail and must have fallen off the bed from the opening at the foot of the bed. No deficiencies cited during this inspection. Exit interview conducted. Due to technical difficulties, a copy of this report was emailed to Administrator for return with signature.