Complaint·November 2, 2023

CONTINUED FROM FORM LIC9099 - A total of five memory care unit resident interviews and five staff interviews were either attempted or conducted during the visit. Regarding the allegation that Staff are not ensuring that hazardous items are inaccessible to residents in care, the following has been concluded: Based on observations made during two separate visits of the memory care unit in addition to staff interviews, it was determined that sharps and toxics were being locked away when not in use. Observations were conducted while care staff was in attendance serving meals. Regarding the allegation that Staff are not ensuring that residents have diapering products, the following has been concluded: Based on interviews, record reviewed and observation made in the memory care unit, it was determined that memory care unit residents could either be provided incontinence supply by the facility, by their families or by hospice services depending on their personal situation and preferences. In each case, measures are in place to prevent staff running out. However, occasional supply issues having to be supplemented were also described with some of the residents admitted on hospice with a specific provider due to practices of one specific hospice staff. It was however not evidenced that residents were ever found in a situation were their incontinence needs could not be addressed altogether. Regarding the allegations that Staff are not following medication orders, and that Staff did not administer medication to residents in a timely manner, the following has been concluded: Based on interviews, observation of administration practices and a review of the Medication Administration records for four randomly selected memory care unit residents, it was found that all orders were being adequately logged in the system and resulted in documented administration. Deviations from the scheduled dispensations are also found to be documented appropriately whenever they occurred due to a resident being out or refusing to take the medication. Regarding the allegation that Facility is not ensuring that an accurate staffing schedule is being posted, monthly schedules are observed to be posted in staff common areas and are complemented with Daily Care Assignments being filled in every day. Staff interviewed denied having had issues with call-outs not being supplemented or not knowing to which shifts they were assigned. The five allegations are therefore found to be Unfounded, meaning that the allegations are false, could not have happened and/or are without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted and a copy of this report was provided to a facility representative.