complaint·May 1, 2025

At approximately 11:00 a.m. on 03/18/25, LPA reviewed a list of residents receiving home health and hospice services. Interview with Staff #3 (S3) at approximately 11:15 a.m. on 03/18/25 and Staff #4 (S4) at approximately 11:20 a.m. on 03/18/25 revealed the facility usually offers residents three (03) options when deciding between home health or hospice agencies. S3 also noted that six (06) residents were assigned a new home health agency, Skilled Home Heath, Inc., on approximately 03/04/25. Record review of consent forms revealed all six (06) residents signed admission consent forms with Visitor #4 (V4) who was an employee of Skilled Home Health, Inc. Telephonic interview with V4 at approximately 9:30 a.m. on 03/19/25 revealed they were directed by their boss at Skilled Home Health, Inc. to enroll the six (06) residents into home health services. Telephonic interview with a representative from Skilled Home Health, Inc. (V5) at approximately 3:00 p.m. on 03/18/25 revealed all six (06) residents were prescribed physician’s orders for the home health services. Interviews with five (05) out of the six (06) residents enrolled into Skilled Home Health, Inc. around 03/04/25 revealed they did not remember signing consent forms and did not recall receiving different choices for home health agencies. Interview with Resident #1 (R1) at approximately 2:20 p.m. on 03/18/25 revealed a representative from a different home health agency solicited services to R1 around February 2025. R1 stated that a facility employee later told R1 “we are going to use our own healthcare” when referencing R1's enrollment into Skilled Home Health, Inc. Interview with V1, who was a representative of Resident #7 (R7), revealed they received a phone call from facility staff telling them that they were going to enroll R7 into hospice services. Interview with V2, who was a representative of Resident #8 (R8) revealed facility staff suggested hospice for R8 and that a hospice agency would reach out to them. Both V1 and V2 stated they were not provided options of hospice agencies to choose. Record review of the facility’s admission agreement at 2:30 p.m. today revealed that residents “may utilize home health agencies, or other providers of [their] choice”. Based on interviews and record review, R7 and R8 enrolled into hospice services without them or their representatives being offered choices of hospice agencies. Out of the six (06) residents enrolled into Skilled Home Health, Inc. around 03/04/25, only R1 was provided a choice of home health agencies. R1 was later told they would be enrolled into Skilled Home Health, Inc. Therefore, the allegation is deemed SUBSTANTIATED at this time. Deficiency is cited on LIC 9099-D page. No immediate health and safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided. Staff duties for the morning and afternoon of 03/18/25 were divided amongst three (03) caregivers. Each caregiver was assigned to provide care for approximately twenty-one (21) residents with needs such as escorting to and from meals, incontinence care, shower assistance, and assistance with other activities of daily living. It was estimated that each caregiver was assigned approximately six (06) hours of work for morning and afternoon shifts. LPA, Administrator, and Wellness Coordinators also reviewed the overnight shift assignments, in which two (02) caregivers were assigned to provide incontinence care and supervision for twenty-eight (28) residents. It was estimated that each caregiver was assigned approximately five (05) hours of work for overnight shifts. Interviews with the three (03) morning caregivers revealed that all caregivers had sufficient time to complete all necessary tasks. Interview with Staff #1 (S1) at 1:55 p.m. on 03/18/25 revealed that they do get short staffed at times when a caregiver calls out sick. Interview with Staff #2 (S2) at 2:05 p.m. on 03/18/25 revealed that they assist other caregivers to complete duties. Interviews with nine (09) out of eighty-nine (89) residents, which was at least 10% of the census, revealed that their care needs are met by staff. Based on record review and interviews, the facility is sufficiently staff to meet the needs of the residents. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. No immediate health and safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided.