complaint·June 4, 2021

It was also confirmed staff in the dementia unit were using a rock or other type of object to crush the medication instead of using an actual medication crusher. Staff were also crushing the medication and putting the medication in a soda and giving the soda to Resident #3 (R3). Facility does not have a order to put the medication in soda. Based on the information obtained, the allegation is substantiated. Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met, therefore the allegation is found to be substantiated. Deficiencies are being cited on the attached LIC 9099D. Exit interview held. A copy of the report and appeal rights were provided to administrator. R1’s records indicate R1 is diagnosed with dementia and according to staff would not be able to communicate during an interview. R1 is currently in a skilled nursing facility due to declining health. Based on the information obtained the allegation is unsubstantiated. Allegation: Staff did not schedule resident's podiatrist appointment. It’s alleged R1’s toenails were long because R1 was not seeing a podiatrist. Staff interviewed reported that the podiatrist was not entering the facility due to COVID-19. The podiatrist started visiting the facility earlier this year. R1 had an appointment but was told they would not take R1’s insurance. R1 was scheduled for another podiatrist appointment, but R1’s health declined and had to be transferred to the hospital in April 2021 and R1 has not returned to the facility. Based on the information obtained, the allegation is unsubstantiated. Allegation: Staff falsifies documents. It’s alleged staff document that residents in the dementia unit are assisted with their medication, but staff don’t actually give the medication. Staff interviewed deny the allegation. LPA reviewed the dementia unit medications and did not find evidence to support the allegation. LPA toured the dementia unit and did not find any residents that would be able to communicate effectively during an interview. Based on the information obtained, the allegation is unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Exit interview held with administrator and a copy of the report was provided.