complaint·July 3, 2023

CONTINUED FROM FORM LIC9099-A Regarding the allegation that Facility staff changed resident’s mailing address without authorization, the following has been concluded: Based on the staff interviews conducted and per facility policy under the Assisted Living Waiver (ALW), facility administrator notified the Social Security Administration of the fact that resident R1 had established residency at the facility after the admission agreement was signed and informed the Social Security Administration of the resulting change of address so relevant information necessary to the establishment of benefits under the ALW waiver could be conducted with no delay. As a result, the allegation is found to be Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Regarding the allegation that Facility did not notify responsible party of resident’s change in condition, the following has been concluded: Based on records reviewed and interviews conducted, there is extensive documentation of exchanges and notification from facility staff to the resident's relatives and responsible party. The allegation is therefore deemed to be Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of this report was printed and left at the facility. CONTINUED FROM FORM LIC9099 LPA agreed to provide a deadline extension to facility administrator so that the records could be found. On July 3, 2023 a follow-up visit was conducted. Facility staff is still unable to provide the records at this time. A type B citation regarding this failure to comply with Title 22 regulations is being issued to the facility on a separate inspection report. Regarding the allegation that Facility did not meet resident’s needs, the following has been concluded: Based on interviews and records reviewed, resident R1 was admitted to the facility on June 8, 2022 upon discharge from St. Jude Hospital where he had been admitted for sepsis. At the time of admission, the resident did not have a hospice care service in place in addition to basic care and services provided at the facility, so facility staff resorted to using Home Health before an eventual hospice admission happened on June 22, 2022. Evidence provided shows that resident received adequate palliative care until his death six days later. As a result, this allegation is found to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred. Regarding the allegation that Facility staff did not follow doctor’s orders, the following has been concluded: Based on interviews and records reviewed, no evidence of non-observance of doctor's orders could be found besides a verbal disagreement with part of the resident's family regarding the quantity of oxygen to be dispensed and comfort measures provided to resident such as repositioning, documentation of which was provided during the initial complaint investigation. Therefore the allegation is found to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred. An exit interview was conducted and a copy of this report was printed and left at the facility.