complaint·October 22, 2025

The facility also put pads on the side of the bed in case R1 fell out of bed at night. According to R1's physician report dated August 18, 2022 R1 was diagnosed with Dementia and could ambulate. A review of hospital discharge paperwork shows R1's CT scans and X-rays were negative and showed no injuries. R1 was advised to drink more water to stay hydrated to help their Kidney function and advised to have a follow up appoint with their primary care physician (PCP) to check on their kidney function. 5 out of 5 staff interviewed reported that R1 is checked on hourly and always assisted. R1 did not respond to questions asked by LPA. The Administrator reported that they have scheduled a meeting with R1's responsible party to discuss their care plan. R1's responsible party could not be reached and was not interviewed. R1 moved out of the facility on December 18, 2023 and has since passed away. After R1 fell on February 5, 2023, the facility took action and since there have been no reports of any incidents involving R1. Based on the evidence gathered the allegation is unsubstantiated, meaning although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.