complaint·March 13, 2024

LPA observed three ALW personal rooms, all of which have a step to get in the shower. LPA interviewed 10 residents (R1-R10), seven (7) out of ten (10) residents have denied the allegation, one (1) resident out of ten (10) have denied the interview. LPA interviewed one (1) witness (W1) from Carelon Hospice and W1 has provided sufficient information to deny R1's fall was based on over-medication or any abuse. Record reviews revealed that resident one ambulated to the hospital via taxi service and that the radiology department observed no fractures throughout R1's body. Based on LPA's observations, record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated. No deficiencies were cited during today's visit. An exit interview was conducted with Veronica Gomez, Administrator (S1), and a copy of this report has been provided.