complaint·March 18, 2023

Staff #5 (S5) at 1:25pm, LPAs observed all three (3) staff members were not wearing their COVID masks appropriately. LPAs informed staff to put the mask up and use it properly. All three (3) staff members immediately complied and pulled their masks over the nose. Based on LPAs observation, during the visit made on 11/23/21, this allegation is deemed Substantiated. Allegation: Residents rooms are not in good condition During the initial visit, LPAs Panushkina and Stamp conducted a physical plant tour of the facility and observed a broken closet door at 11:25am. In addition, at 11:56am LPAs observed the bathroom vanity in one of the resident rooms was in a bad condition and dirty. At 12:58pm, LPAs observed a cut out in the wall behind the residents’ entrance door. During todays visit LPA Panushkina observed and confirmed that all previously mentioned issues have been resolved/fixed. Based on LPAs observation, during the visit made on 11/23/21, this allegation is deemed Substantiated. Deficiency cited on LIC9099-D Exit interview conducted, appeal rights explained and copy of this report signed and delivered. on 11/17/21, during the morning rounds in a Memory Care Unit, staff discovered R1 sitting on the bathroom floor. LPA was informed that although, R1 had an unwitnessed fall and sustained a minor injury, an immediate care was provided by the facility MedTech. Thus, there was no evidence of neglect/lack of supervision. Based on the information gathered, this allegation is deemed Unsubstantiated. Allegation: Staff did not allow resident representative to document an injury It was alleged that on 11/18/21, facility staff refused the Reporting Party (RP) to take pictures of R1 due to the incident that occurred on 11/17/21. To investigate this allegation, during the initial visit (made on 11/23/21) LPAs conducted an interview with the Resident Care Director (RCD) at 10:25am. Interview with RCD confirmed that on 11/18/21 RP visited the facility and was not allowed (by the facility staff) to take pictures of R1 without getting the consent from R1’s primary responsible party. Based on the information gathered, this allegation is deemed Unsubstantiated. Allegation: Staff did not provide incident report of unexplained injury It was alleged that on 11/18/21, facility staff would not provide Reporting Party with the incident report for R1. To investigate this allegation, on 11/23/21 LPA Panushkina reviewed all LIC624’s (Unusual Incident/Injury Report) submitted to the Regional Office (RO) from 11/16/2021 to 11/23/2021. Review of documents revealed that a total of nine (9) Incident Reports have been submitted to RO, regarding random residents, and LPA did not observe R1’s incident that occurred on or about 11/16/21 or 11/17/21. However, the facility provided R1’s Incident Report to LPA indicating that the form was filed and submitted to the Regional Office. Based on LPA record review and observation this allegation is deemed Unsubstantiated at this time. Allegation: Staff do not assist resident with incontinence needs It was alleged that R1 always smells of urine and his/her clothing is always soaked in urine. To investigate the allegation, during the initial visit conducted on 11/23/21 at 11:30am, LPAs Panushkina and Stamps made observations during a physical plant tour. LPAs did not experience any malodor and all observed residents were clean and well groomed. In addition, during the attempted interview with Resident #1 (R1) at 12:05pm, Continue on LIC9099-C LPAs observed R1’s clothes dried, clean and R1 appeared to be well groomed and looked and smelled fresh/clean. Finally, interviews with staff also revealed that residents are changed regularly and that they are not left soiled for an extended period. Based on observations and interviews, there is not enough information to verify the allegation, therefore, the allegation is Unsubstantiated at this time. Allegation: Residents toilets not in good condition To investigate this allegation, LPAs Panushkina and Stamp, during the initial visit conducted on 11/23/21, inspected three (3) resident rooms and observed all toilets were in good condition and were properly operating. In addition, during today’s visit (03/18/23), LPA Panushkina inspected an additional three (3) resident rooms between 1:25pm and 1:30pm and observed all bathroom toilets are in good and working condition. Based on LPA record review and observation this allegation is deemed Unsubstantiated. Exit interview conducted and copy of this report signed and delivered.