Follow-up on corrections·September 15, 2022

On 9/15/2022, Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced Case Management Deficiencies visit due to deficiencies observed during the investigation of complaint control #29-NP-20211202105836. LPA Urena met with the administrator Marat Davidian and explained the reason for the visit. During the investigation, the LPA learned while interviewing staff, that staff were providing care for R1’s pressure injury. R1’s pressure injury developed while in the care of the facility. On 11/017/2021, records review of Home Health Care Services revealed that HHCS staff reported that upon R1’s skin assessment, it was observed that there was an open wound on the sacral area with a diameter of 2cm. x 3cm. The physician ordered wound care for R1. HHCS staff provided the wound care per the physician’s orders, and instructed facility staff to observe the wound, and provide wound care regimen daily. The LPA was concerned what type of “wound care” the staff was providing, as only appropriately skilled professionals (Licensed Vocational Nurse [LVN] or higher) are allowed to provide wound care for pressure injuries. On 08/29/2022, staff interviews revealed that staff kept the wound area clean, by irrigating the wound with a cleaning solution, applying ointments around the wound area, and covering the wound with a dry dressing. The administrator’s interview revealed that they were aware of the change in condition, and stated that staff was instructed to only change the dressing and apply moisture cream around the sacral wound. Only appropriately skilled professionals are allowed to care for pressure injuries. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Civil penalties assessed. Citations were issued. Exit interview conducted with the administrator, and signatures were obtained. A copy of the report and Appeal Rights were issued.