complaint·January 7, 2026

Regarding the allegation: Resident became dehydrated while in care due to staff neglect . It is being alleged that resident #1 (R1) was dehydrated upon arrival at the hospital. LPA conducted three (3) staff interviews that confirmed R1 would eat blended food as drinks including ensure. Additionally, LPA interviewed R1's spouse that confirmed R1 was not dehydrated. R1's spouse stated, "that R1 was losing weight at home and had lost a total of thirty (30) pounds and they could no longer take care of R1 so R1 was admitted to the facility on 12/05/25. R1's spouse also indicated that R1's doctor had R1 do blood work, a ct scan and ultra sound just to make sure R1 did not have cancer." Furthermore, R1 was under Hospice/Palliative Services. LPA interviewed R1's nurse that was taking care of R1 and they stated, "R1 would eat and drink in small portions, R1's diagnosis was dementia and R1 was able to use the bathroom-had wet soil on their diaper so R1 was not dehydrated." LPA interviewed two (2) residents that confirmed they eat very well and get all their meals. Furthermore, LPA reviewed and obtained, R1's preplacement appraisal, admission agreement, Medical Assessment, Identification and Emergency Information and Hospice notes that indicate R1 had dementia and was on a puree diet. Therefore, based on the record review and interviews conducted the allegation is UNSUBSTANTIATED at this time. Regarding the allegation: Resident became malnourished while in care due to staff neglect. It is being alleged that resident #1 (R1) was malnourished upon arrival at the hospital. LPA conducted three (3) staff interviews that confirmed R1 was on a puree diet and would have to eat all their foods blended. In addition, LPA interviewed R1's spouse that confirmed R1 was not eating much prior to going to the facility and furthermore, they would visit R1 almost everyday and they were trying to feed R1, it was not the facility's fault." R1's spouse also stated, "that R1 had lost a total of thirty (30) pounds prior to being admitted to the facility on 12/05/25. Furthermore, R1 was under Hospice/Palliative Services. LPA interviewed R1's nurse that was taking care of R1 and they stated, "R1 would eat and drink in small portions, R1's diagnosis was dementia and R1 also had aspiration problems so we had to be careful when feeding R1. LPA interviewed two (2) residents that confirmed they eat very well and get all their meals. Furthermore, LPA reviewed and obtained, R1's preplacement appraisal, admission agreement, Medical Assessment, Identification and Emergency Information and Hospice notes that indicate R1 had dementia and was on a puree diet. R1's medical assessment on 12/03/25, shows that R1 weighed 134llbs and R1's nurse visit on 12/16/25 indicated that R1 weighed 150lbs and actually gained weight while at the facility. Therefore, based on the record review and interviews conducted the allegation is UNSUBSTANTIATED at this time. An exit interview was conducted, no citation(s) were issued for the above allegation(s), and a copy of this report was given to the Administrator.