complaint·February 13, 2023

In regards to the allegation "Resident(s) emergency buttons are not working." it was alleged that the emergency buttons in R1 room were not working. (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviewed could not corroborate the allegation. LPA observed room #222 and pressed the emergency buttons during the initial visit. LPA observed staff arrive to check on the room and turn off the signal in sufficient time. LPA also tested the emergency button in room # 218 and observed the same response. Interviews with staff did not state that the emergency buttons were not working at any time. Based on the interviews conducted and observations, the investigation revealed; 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 In regards to the allegation "Resident sustained unwitnessed falls while in care. " it was alleged that R1 was alone and had two unwitnessed falls in the facility. (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviewed could not corroborate the allegation. LPA was not provided with dates of when the falls occurred. LPA reviewed facility files and R1's file and did not observe incident reports of R1 sustaining falls in the facility. Interviews with staff did not show R1 had unwitnessed falls in the facility. Based on the interviews conducted and records review, the investigation revealed; 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 In regards to the allegation "Resident was left unattended for an extensive period of time while in care." it was alleged that R1 had to wait for extensive periods of time to receive help from the staff. (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviews could not corroborate the allegation. Interviews state that staff perform routine check ins to resident rooms when they are not out in community rooms. Interviews do not state that staff will ignore residents in need of help. LPA observed, both on 6/1/22 and 2/13/23, that staff periodically walk into resident rooms to check in on residents. Based on the interviews conducted and observations, the investigation revealed; 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 In regards to the allegation "Resident is not being fed a sufficient amount of food while in care." it was alleged that on 5/22/22 R1 was not being provided a sufficient amount food and was hungry... Continued on LIC 9099-C (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviews could not corroborate the allegation. Interviews stated that the facility provides breakfast, lunch, and dinner to residents every day. The facility will also provide seconds to residents when they request it and even provide snacks. Interviews do not show that staff was aware of R1 not being given a sufficient amount of food on 5/22/22. Based on the interviews conducted and observations, the investigation revealed; 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 In regards to the allegation "Facility motion detectors are not working." it was alleged that the motion detectors in resident rooms are not functioning. (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviews could not corroborate the allegation. Interviews with staff stated that the motion detectors located in resident rooms send signals to the beepers that staff carry. The motion detectors are used as a way to monitor a residents location throughout the day but are not the same as an emergency signal. LPA observed the motion detector in room #222 and #218 to operational on the initial visit. Based on the interviews conducted and observations, the investigation revealed; 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 In regards to the allegation "Not enough staff to meet residents needs" it was alleged that there is not enough staff present in the memory care unit to meet all the residents needs. (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviews could not corroborate the allegation. Residents interviewed did not state that there are staffing issues in the facility. During the initial visit on 6/1/22, interviews with staff show that the facility keeps 3 caregivers and 1 med tech staff on each shift for the memory care unit alone. At that time there were 17 residents in the memory care unit. LPA confirmed the information via staff roster. On todays visit LPA observed 4 care giving staff and 1 med tech working in the memory care unit providing assistance and meals to residents in care. Based on the interviews conducted with clients and staff as well as observations and record review, the investigation revealed; 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 Continued on LIC 9099-C In regards to the allegation "Staff told Resident to use their diaper instead of assisting them to the bathroom." it was alleged that R1 needed assistance to use the restroom but staff denied helping and told R1 to use their diaper instead. (6) of (6) staff interviewed denied the allegation. (5) of (5) Residents interviews could not corroborate the allegation. LPA was not provided with a name of which staff refused to assist R1. LPA not provided when a date of the incident occurred. Interviews with staff do not show knowledge of any staff speaking to R1 in this manner. Based on the interviews conducted, the investigation revealed; 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 conducted and a copy of this report was provided.