complaint·September 13, 2023

CONTINUED FROM FORM LIC9099 Regarding the allegation that Facility staff neglected resident resulting in unstageable wounds, the following has been concluded: Resident R1 was admitted on November 2, 2021, at the facility as well as onto hospice care on the same day. The hospice terminal diagnosis indicates a history of Muscle Weakness, metabolic encephalopathy and protein-calorie malnutrition upon admission. Per the initial appraisal, R1 is stated to be on regular mechanical soft diet, uses a wheelchair to ambulate and has a foley catheter in place due to a diagnosis of incontinence. On November 13, 2022, R1 was transferred to MemorialCare Orange Coast Medical Center and admitted with a diagnosis of Altered mental status, Acute cystitis without hematuria and Severe sepsis. At the time of the hospitalization, R1 was discharged from hospice to allow for the transfer, as confirmed by discharge notes dated November 15, 2022. The records provided by the hospice care provider include daily logs dated from August 12, 2022 until November 13, 2022. A minimum of two weekly documented occurrences of wound care are apparent on the notes maintained by hospice staff in their care for the resident. Hospice staff notes indicate that on October 26, 2022, resident was assessed with " no new skin issues, continues with sacral coccyx wound currently stage II (with a history of Unstageable with 100% yellowish slough with redness to surrounding area and redness to perineal area). Site slowly healing with small opening, no signs/symptoms of infection, Private Caregiver may change dressing and reapply Calmoseptine if soiled or dislodged. " Photographs on file document the sacro-coccyx wound are present and are consistent with hospice progress notes. Facility caregivers are noted to be "competent and knowledgeable with all treatments" involved in providing wound care to resident. A follow-up hospitalization occurred on December 12, 2022, and includes wound care progress photographs that evidence the slow rate of healing consistent with the failure of nutrition causing the breakdown of tissue due to R1’s condition. A family member reported satisfaction with the care R1 received and is still receiving at the facility at this time. Staff stated that R1 was readmitted at the facility and is no longer receiving hospice care due to the wound having healed. Based on the records reviewed and interviews conducted, there was no evidence to support the allegation, therefore the allegation is determined to be Unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of this report was provided to a facility representative.