complaint·April 19, 2022

When family arrived they asked staff to call 911. Paramedics checked R1's blood sugar and it was 345. R1 was transferred to the hospital. According to medication documentation, R1 had been refusing insulin medication since September 2021. Facility was updating the family and physician on each occurrence. On 10/18/21, facility documented again that R1 refused insulin medication. Physician noted "Will hold insulin for now". From 10/19/21 to 10/24/21, facility did not assist with insulin due to physician's orders. On 10/22/21, facility noted R1 refused to eat lunch. Family was notified. On 10/24/21, facility noted R1 appeared weak in the morning. R1 was assisted with toileting and was escorted to the dining hall for breakfast. R1 ate very little. Facility checked on R1 at noon the same day and R1 appeared to be resting. R1 was asked if he/she wanted to go to the hospital and R1 said no. Family was notified of the incident. Family visited the facility at approximately 1:20 pm and asked staff to call 911 because R1 appeared weak. R1 is no longer a resident of the facility and was therefore not interviewed. Residents interviewed describe the staff as "good" or "great". Staff interviewed remember R1 and indicated R1 regularly refused medication and started to refuse meals. Caregiver also indicated R1 sometimes refused assistance with toileting. On 10/24/21 staff did not call 911 because it was not unusual for R1 to refuse to eat or refuse care. Staff did not give insulin since the physician ordered the insulin be held. Based on the information obtained, the allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview held. A copy of the report was provided.