complaint·March 3, 2022

Her duties include scheduling and supervising caregivers. S1 denies assessing for resident's care, signing prescription forms that are sent to the pharmacy, and placing residents on hospice care, even if the residents do not qualify. S1 states only the administrator, who is a licensed nurse does the assessment and reassessment for the residents to insure their needs are being met. S1 states she doesn't sign any refill prescription forms. Resident medications are bubble pack. It gets refilled automatically every 28 days. For prescription medicine that are as needed or in a bottle, either her or another medication staff would call the pharmacy within five days of the prescription medication running out to request a refill. S2, who works for marketing also states she is not a nurse. Some of her duties include processing admission paper work, marketing, and sometimes assist with medications as she previously held the position of a med tech. S2 also denies assessing for resident's care, signing prescription forms that are sent to the pharmacy, and placing residents on hospice care, even if the residents do not qualify. S2 states she may go with the administrator to assist her with resident paperwork, but doesn't do any of the assessments. According to the administrator, she primarily does the pre-assessment/appraisal of the resident prior to admission. She determines them for appropriateness and compatibility. In regards to signing off on documents for hospice care, the administrator denies doing so. She states she is in communication with hospice agency constantly to insure the resident needs are being met. Based on the information obtained it could not be proven that unqualified staff are assessing resident's care or signing off on resident's documents. Therefore, the allegation is deemed Unsubstantiated at this time. Resident's care is not being assessed for a higher level of care: In regards to the allegation it's being alleged that there are dementia residents and residents with severe psychiatric issues that shouldn’t be in assisted living. Reporting Party (RP) alleges that unqualified staff has been signing all forms that are sent to the pharmacy. RP stated that residents are being placed on hospice that don’t even qualify for it because they get a kick back. RP stated that there are 35 residents on hospice and that staff are signing off on that paperwork and not the doctor. Interviews with the administrator and staff reveal that they deny placing residents on hospice or signing off on their paperwork to receive kick backs. Staff stated that only the resident doctors makes the referral of residents to the hospice agency of their choice. The administrator states that she is constantly in communication with the resident's doctor and the hospice agency to insure the resident needs are being met. Currently the facility has 24 residents that are receiving hospice care. The administrator, who also holds an LVN license, stated she primarily does the pre-assessment/appraisal of the resident prior to admission. She determines them for appropriateness and compatibility. Review of records reveal that the facility utilizes three different hospice agencies. Regarding unqualified staff signing all forms that are sent to the pharmacy, both the administrator and staff indicate that medications are bubble pack and refilled automatically every 28 days. For PRN or bottled medication, the med tech would call the pharmacy 5 days prior to the medication running out to request for a refill. Staff confirms that only the doctor signs off on the resident's prescriptions and refills. Based on the information obtained it could not be proven that resident's care is not being assessed for a higher level of care . Therefore, the allegation is deemed Unsubstantiated at this time.