Complaint·November 19, 2025

Continued from LIC9099 Incident Report for R1 received on 05/30/2024 stated that R1 had an unwitnessed fall on 05/27/2024 and sustained a small cut to their eyebrow. Report further stated facility notified R1’s responsible party and contacted Hospice for further instructions. Based on staff interviews conducted, facility staff applied first aid and contacted the hospice nurse. Per staff interviews, the nurse conducted a telephone assessment and determined that R1 did not have a head injury since R1 was able to respond appropriately. Per facility documents, R1’s hospice agency visited on 05/28/2025 for a follow-up. Review of hospice documents indicated that R1 denied hitting their head and denied having post-fall pain. Based on record review, interviews conducted, and observations made, this allegation is Unsubstantiated. A finding that a complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents. Continued from LIC9099A LPA conducted interview with R1’s Responsible Party. Per Responsible Party, they have had no concerns regarding R1’s care at the facility. They have never observed R1 to be bruised or “black and blue,” on their back, bottom, or face. Responsible Party stated that they have seen sores or bruises on R1 before but they have always been aware of where the injuries came from. Responsible Party further stated that the facility provides them with a report about R1 every day and that they have never found or observed loose pills at the facility or pills in R1’s pockets. Responsible Party stated that the information being investigated is false and could not be true. Based on record review, interviews conducted, and observations made, these allegations is Unfounded . An allegation that is Unfounded, means that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.