complaint·May 12, 2025

Between 11:00am – 12:00pm, LPA interviewed two (2) staff, one (1) out of four (4) residents and the Licensee. Between 12:30pm and 1:30 pm LPA interviewed two (2) nurses visiting residents at the facility. Allegation: Facility staff hit resident in the face. It was reported that Resident #1 (R1) was hit by Staff # 1(S1) on the face. Previous visit to investigate the allegation above was conducted on 8/1/2024. During the initial visit, LPA reviewed residents’ records, conducted interviews with one (1) out of six (6) residents who was verbal and able to communicate to answer questions, two (2) staff members, a nurse from Home Health, who was treating R1 at that time, and the Administrator. Information obtained through interviews with staff members and the nurse, reveal they have never witnessed or heard R1 or any other resident in care hit by S1 or any other staff members. LPA did not observe any bruises or scratches on R1’s face. Based on the information obtained, interviews and observations, this allegation is deemed Unsubstantiated at this time. Allegation: Facility staff did not assist resident with transfers. It was reported that R1 wants to visit his Church, however, staff does not assist R1 with transfers. To investigate the allegation, LPA conducted interviews with two (2) staff members, administrator, and Home Health nurse who visits and treats R1 daily. All parties interviewed revealed that R1 gets transferred from his bed to incline chair and vice versa as he/she wishes. No staff member leaves R1 on the chair for a long period of time considering R1’s health condition. R1's both legs are amputated, wears diapers, has very fragile skin and easily gets rashes, hence, staff is very careful not to leave R1 in one position to avoid skin issues. R1 was advised not to visit church during the heat wave because R1 won’t be able to seat for long period of time on the wooden uncomfortable chairs. To avoid health issues and skin wounds, R1 was suggested to wait till the weather will get a little cooler. Interview with Home Health nurse also stated that during the extreme heat weather it is not suggested for R1 to be outside or be seated on the chair for a long period of time. During the visit LPA observed that R1 had a radio and TV in his/her bedroom and was listening to religious channel. Based on the interviews, observations and information obtained LPA did not find enough evidence that staff is violating resident’s personal rights, therefore, the allegation is deemed Unsubstantiated at this time. Allegation: Facility staff handled resident in a rough manner: It was alleged that R1 was being treated by S1 in roughly manner. To investigate this complaint, LPA conducted interviews with two (2) staff members, administrator, and one witness – R1’s home health nurse who visits every day for treatment. During interviews parties denied ever heard or witnessed S1 mistreating R1 or any other resident in care in a roughly manner. Based on the interviews and observations this allegation is deemed Unsubstantiated. Allegation: Facility staff yelled in resident's face It was reported that S1 and S2 yell on R1’s face. To investigate the allegation, LPA conducted interviews with two (2) staff members, administrator, and Home Health nurse who visits and treats R1 daily insulin shots. All parties interviewed stated that no staff member yells or disrespect R1 or any of the residents in care. Administrator revealed that all employees have their training up to date and are well trained how to speak and handle residents’ in care. Interview with witness confirmed that any abuse would not stay unnoticed by her/him and would have been reported. Based on the interviews and observations this allegation is deemed Unsubstantiated. Allegation: Facility staff refused to provide clothing to resident It was alleged that S2 denies providing proper clothing to R1. To investigate this allegation, LPA conducted interviews with two (2) staff members, administrator, and Home Health nurse who visits and treats R1 daily for insulin shots. During interviews parties denied and stated that R1 does not allow anyone to turn on the AC during the hot summer weather and does not allow his/her bedroom door to stay open for air circulation. Staff does not refuse to give warm clothing to R1, but considering R1’s health issues they prevent R1 of having heat stroke by not dressing R1 with very thick clothing. LPA observed R1’s clothing dresser with proper organized clothing and noticed extra blankets next to R1’s bed. Based on the interviews and observations this allegation is deemed Unsubstantiated. Allegation: Facility staff took away resident's phone: It was alleged that S1 and S2 took away R1’s phone and did not charge the phone. To investigate this allegation, LPA conducted interviews with two (2) staff members, administrator, and Home Health nurse who visits and treats R1 daily for insulin shots. Interviews revealed that facility does not have phone restrictions and R1 always has his/her cell phone under his/her supervision. During the visit, LPA observed R1’s phone was placed on the chair by R1’s bed. Based on observations and interviews this allegation is deemed Unsubstantiated at this time.