complaint·February 21, 2025

R1 was independent and refused assistance. All staff interviewed said they would help R1 when called or needed assistance. Per interview with R1, they indicated they were independent and did not need assistance only when asked. R1 said the facility staff helped them as best as they could. Per records obtain, it was not until R1 went to the hospital in October for weakness and a urinary tract infection, that they discovered R1’s wound. The hospital provided outpatient care and home health services to care for the wound. All staff interviewed, and ED Chon indicated that after R1 came back from the hospital and said that home health services was responsible for taking care of R1’s wound. Two out of two staff interviewed indicated that they helped occasionally with cleaning and bandaging the wound when R1 asked for assistance when home health was not present. All staff interviewed said they check on her everyday and said that R1 never complained or said anything. Based on records obtain, an internal incident report for December 23, 2024, a home health nurse asked Staff 1 (S1) to call 911 to send R1 out because their wound got infected. S1 also said that the home health nurse who asked them to call 911, explained a previous home health nurse did not properly care and bandaged the wound for R1 which resulted in the wound getting infected. When interviewed about home health care, R1 said that they were taking good care of them and had no problems with the services provided. Facility staff and the ED thought home health service was taking proper care of R1’s wound until 911 had to be called and the home health service did not indicated or communicated anything to the facility. Therefore, based on LPA Tea's observations and interviews conducted and records review the allegation that staff did not ensure resident’s wound care needs were met has been determined to be unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiencies cited at this time and an exit interview was conducted with Executive Director Chon over the phone and a copy of the report and confidential names list was provided to the facility.