complaint·July 14, 2025

On 02/19/2024, two caregivers saw R1 get up from the dining room chair, walk over to the dining room window and walk right into a chair which may have contributed to R1 banging their head on the window as they turned their head. One of the caregivers attempted to stop R1 prior to R1 walking into the chair. R1 was assessed by LVN; no bruises or marks were noted at the time. The LVN had applied an ice pack to prevent swelling. R1’s physician was notified and advised staff to keep an eye on the resident during their rounds. R1 did not complain of pain when they hit their head. On 02/24/2024, when R1 family visited, they noticed bruises on R1s forehead, they were told it was due to the incident that occurred on 02/19/2024, which they were not informed of. R1s physician was notified about the bruises and bump on R1s forehead on 02/24/2024 and advised for R1 to be sent to the hospital for an evaluation. R1 did not suffer any internal injuries requiring medical treatment. R1 was ambulatory during the time of their injury and the facility staff had acted appropriately during the incident on 02/05/2024 and on 02/19/2024, notifying the LVN and R1’s doctor. On 02/24/2024, when the bruises on R1s forehead became apparent, R1 doctor was notified immediately, and was sent out of the facility for medical evaluation. Interviews with staff stated residents have the right to refuse to eat and the do not force any resident to eat. Based on the interviews it cannot be proved or disproved Based on this interviews and records reviews, this allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are unsubstantiated