complaint·May 25, 2023

Continued LIC9099-C page 2 Allegation: The facility is not adhering to the approved hospice waiver Staff 1-2 (S1-S2) stated the facility staff is adhering to the approved hospice waiver. S1-S2 stated the facility is approved for one (1) hospice waiver. S1-S2 stated that the facility has a waiver for 1 terminally ill resident to receive care from a hospice agency, the licensee obtained an approved facility hospice care waiver from the Department. The hospice care services are only provided to 1 resident living at the facility. S1-S2 stated the facility does not have 5 residents on hospice care, the facility only has 1 resident in hospice. S1-S2 stated the facility currently has six (6) residents in placement and 1 resident in hospice. S1-S2 denied the allegation. Investigation revealed the following: Interviews were conducted with staff 1-2 (S1-S2) who stated the facility only has one (1) resident on hospice and has an approved hospice waiver for that resident. During today's visit, LPA Bunker only observed 1 hospice resident in placement. Resident records indicated only 1 resident was in hospice. LPA Bunker observed the facility license posted on the hallway wall that stated the facility is licensed to serve six (6) residents age 60 and above, five (5) non-ambulatory, 1 bedridden, and a hospice waiver approved for 1 resident. The licensee has obtained a facility hospice care waiver from the Department. R1 stated she is receiving hospice care. R2-R6 stated they are not receiving hospice care. R1-R6 stated they are happy living here and the staff takes good care of them. S1-S2 stated the allegations are false. Staff 1-2 (S1-S2) interviewed denied the allegation. Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated. A copy of the Complaint Investigation Report LIC 9099 and LIC9099-C, was provided to House Manager Ronnie Coronacion and Assistant Administrator Rhoda Mabutas. There were no deficiencies cited. An exit interview was conducted.