Incident investigation·March 10, 2022

This unannounced case management visit is being conducted by Licensing Program Analyst (LPA), Kathrina Chin to follow up on resident 1 who self overdosed on Norco on 2/27/2022 and passed away on 3/3/2022. LPA arrived at facility and initially met with Jennifer Cortez, LVN/Wellness Nurse. Nicki Hulquist, LVN/ Resident Health & Services Director arrived thirty minutes later and LPA explained the nature of the visit. LPA Chin spoke to Richard Nordsiek, ED over the telephone upon arrival at the facility. On 2/27/2022, resident 1 was sent out to the St. Jude Medical Center and returned to the skilled nursing facility, Park Vista, on 3/2/2022 of this Continuing Care facility. Resident 1 was placed on hospice on 3/3/2022 and passed away that evening. Resident 1 had a DNR and POLST on file. R1 was in the independent living section of the facility. LPA reviewed R1's physician's report and it was indicated that resident 1 is able to administrator her own prescription medications and was able to leave the facility unassisted. LPA requested records such the Needs and Services plan, physician's report, pre-admission appraisal and medication list for resident 1 and was provided by Nicki Hulquist, RHSD. A copy of the hospital records from St. Jude Medical Center was also provided. At this time, based on the information available, there are no deficiencies being cited per Title 22, Division 6 of the California Code of Regulations . An exit interview interview was conducted and a copy of this report was provided to the facility.