Complaint·December 15, 2021

According to facility documentation, R1 had a private care giver available during the hours of 7 am to 7 PM, Monday through Friday and from 7am to 3pm on the weekends. It was also discovered that on 5/13/2019, the facility reported to R1's responsible party that R1 had a change of condition and recommended physical therapy, which R1 had declined on two previous instances. Based on facility documentation and staff and resident interviews, this allegation is deemed UNSUBSTANTIATED at this time. Allegation 2. Facility failed to administer medication as prescribed by physician LPA was able to review R1's medication documentation in order to come to findings for this allegation. This facility uses a QuickMAR computer system in order to dispense medications to the residents. This program provides staff with a photo of the resident and the times and quantities that a specific medication will be dispensed. The LPA was able to review R1's QuickMars print out sheet, which outlined all prescribed medications and PRN medications. According to the facility documentation, all of R1's medications were given as prescribed. PRN medications were also dispensed on several occasions and were documented on the QuickMars print out. Based on a review of R1's medical documentation, this allegation is deemed UNSUBSTANTIATED at this time. Allegation 3. Facility failed to observe resident's change in condition LPA was able to review the progress notes for R1 in order to come to findings for this allegation. On 11/22/2019, the LPA was able to gather progress notes of R1 beginning in April of 2016 and ending in November of 2019. The progress reports indicated that staff was aware and had been documenting and informing the responsible party regarding changes in R1's condition. The first change of condition was observed on 4/5/2017 and the responsible party was notified. More recently, a change in condition was observed on 5/13/2019 and a health and service evaluation was conducted on 5/26/2019. Another health and service evaluation was conducted on 7/4/2019 and again on 7/23/2019 as R1's condition continued to change. Based on a review of facility documentation, this allegation is deemed UNSUBSTANTIATED. Continues on LIC 9099-C Allegation 4. Facility failed to report resident's change in condition to responsible party LPA was able to review facility documents in order to come to findings for this allegation. On 11/22/2019, the LPA was able to gather progress notes and health and service evaluation reports for R1 beginning in April of 2016 and ending in November of 2019. The progress reports indicated that staff was aware and had been documenting and informing the responsible party regarding changes in R1's condition. Staff indicated that when changes to a residents care plan are to take place, a health and services evaluation will be conducted. A change in condition was observed on 5/13/20/19 and a health and service evaluation was conducted on 5/26/2019. Another health and service evaluation was conducted on 7/4/2019 and again on 7/23/2019 as R1's condition continued to change. A copy of the signed and revised service plan by R1's responsible party was provided to the LPA during todays visit. Based on a review of facility documentation, this allegation is deemed UNSUBSTANTIATED.