Complaint·January 27, 2026

CONTINUED FROM FORM LIC9099-A Regarding the allegation that Resident not administered medication as prescribed , the following has been concluded: Resident R1 was briefly hospitalized at Providence Mission Hospital on January 20, 2022. Per the hospital report reviewed, R1 had been seen by their primary care provider in the weeks prior and prescribed a course of antibiotics for a urinary tract infection, which is alleged to not have been provided adequately to R1 by facility staff. Per a review of R1's hospital records, it was confirmed via testing that the infection treated had been resolved at the time of the admission to the emergency department for weakness and dehydration. A review of the Medication Administration Records provided additionally corroborates the medication being dispensed adequately. Regarding the allegation that Staff disposed residents medication , the following has been concluded: Upon R1's passing on February 8, 2022, facility staff proceeded to destroy the resident's medication as mandated by Section 87465(i) of the California Code of Regulations stating that " Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record nor disposed of according to the hospice’s established procedures or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Both shall sign a record ". The record in question was provided during the investigation and added to the investigation file. Based on the evidence gathered, both allegations are determined to be Unfounded, meaning that the allegations are false, could not have happened and/or are without a reasonable basis. An exit interview was conducted and a copy of this report was provided to a facility representative. CONTINUED FROM FORM LIC9099 Regarding the allegation that Facility did not notify responsible party of change of condition for resident , the following has been concluded: R1 was seen by their primary care provider in early January 2022 following the occurrence of a urinary tract infection with the knowledge of R1's attorney-in-fact. Identically, the hospitalization report dated January 20, 2022 shows that the attorney-in-fact and responsible party was informed of the call to the paramedics due to the resident's lethargic state. The admission on hospice care was initiated the same day with full knowledge of the responsible party. Charting notes following R1's readmission at the facility show multiple contacts with R1's family. Regarding the allegation that Staff mismanaged residents medication , the following has been concluded: It was alleged that after R1 was placed on medication management by facility staff after being assessed to no longer being able to handle their own medication in their physician report reviewed, some PRN medication (nitroglycerin prescribed as needed for R1's heart condition) had been left unaccounted for and accessible to the resident. Aside from one witness statement obtained during the investigation, no evidence of the presence of accessible prescription medication was provided to licensing staff. Regarding the allegation that Staff did not ensure resident is provided an adequate amount of water , the following has been concluded: Upon being admitted to the Emergency Department at Providence Mission Hospital on January 20, 2022, R1 was diagnosed with acute kidney injury secondary to dehydration and provided with two liters of intravenous liquids. Per the hospital report reviewed, R1 was alert and oriented at the time and was not documented as having any form of severe cognitive impairment. The hospital physician noted that R1 had been refusing to eat and drink in the days prior to the call to the paramedics. Based on the evidence gathered, the three allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred. An exit interview was conducted and a copy of this report was provided to a facility representative.