Incident investigation·October 21, 2022

At approximately 8:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a case management visit in regards to an incident report submitted to CCL on 10/20/2022. LPA met with Executive Director Jeannette Kinney and reviewed records. The incident report was in regards to an unexpected death of a resident. LPA reviewed resident records and observed resident was seen by paramedics on 10/18/2022, and declined to be transported to the hospital. Based on records reviewed, paramedics did not advise resident they needed to be seen and appeared to look okay. Based on a record review, resident was discharged from the hospital on 10/03/2022 and seen in the emergency room again on 10/08/2022. Resident was observed on 10/19/2022 at breakfast and lunch, sitting in a chair, alert and responsive. Facility staff were conducting rounds at approximately 1:45PM, and found resident in their room, unresponsive. Staff immediately called emergency personnel. Emergency personnel arrived at approximately 2:00PM. Based on record review and interviews conducted, facility followed proper protocol and regulation. No citations issued during this visit.