Incident investigation·January 12, 2023

On 01/12/2023, Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced to conduct a Case Management Incident visit. LPA met with Administrator, Derbbie Ninobla, and explained the purpose of the visit. The purpose of the visit is to gather additional information regarding an unusual incident/injury report that was sent to Community Care Licensing (CCL) on 01/11/2023. The report indicates that Administrator observed R1 has not been eating for a few days, groaning, and showed signs of weakness. R1 notified Administrator they had chest pain. Administrator called for an ambulance and resident was transferred to the ER. LPA interviewed Administrator regarding incident report. Administrator stated R1 has been transferred to the hospital about seven (7) times. Administrator stated R1 had a change of condition and the facility is unable to meet R1's needs. Administrator stated R1's Social Worker has been in contact and notified Administrator R1 will not be returning to the facility and will be placed at another facility. LPA request for Administrator to follow up with R1's Social Worker and find out where resident will be placed. LPA requested for R1's incident reports, physician's report, needs and services plan, and discharge medical documents. At this time, deficiencies are not being cited. Exit interview conducted and report provided.