Complaint·April 1, 2026

Record review reveals R1’s last physician report was completed 10/31/23 to 11/22/23 clear of any declining health or behavioral changes noted. There is a notification of incident or change of condition document on 04/16/24 and 04/17/24 regarding aggressive language and behavior disturbance however no assessments for the resident were completed following those incidents. Two (2) of two (2) staff reveal R1 sending numerous email messages and are not taking their medication. Interviews with the executive director reveal that there are not any current year reappraisals for R1 documenting any changes in behavior, non-compliance with medication including no written warnings or notices to R1 noting any failure to comply with state, local law or any violations of community rules. Additional interview conducted today with executive director reveal no new evictions for R1 exist for year 2026. Additional interview with R1 states has not received a new eviction for this year but didn’t remember receiving the results of the investigation. Based on record review and interviews there is sufficient evidence to support the allegation of unlawful eviction. Therefore, the allegation is deemed Substantiated at this time . Insufficient staffing to meet the needs of incontinent residents In regard to the above allegation this allegation is the same or similar allegation to previous complaint number: 31-AS-20250806114836 which has already been investigated and substantiated. To investigate the allegation: LPA Smith conducted interviews with staff and R1 from approximately 11:10 am 12:00 pm. Interview conducted with executive director revealed she is still having issues finding and retaining competent caregivers as the hired staff will either quit within the same day or a week starting the position and some of the applicants do not continue with the hiring process. Although hiring process is still on going, observation by licensing staff on previous visits to the facility has observed staff shortage. Based on interviews and observation there is enough information to verify the allegation. Therefore, the allegation is deemed SUBSTANTIATED at this time