complaint·April 9, 2026

It was alleged Facility staff are not addressing a change in the residents condition. Concerns were raised about staff members not addressing changes in condition. Interviews with multiple staff members revealed that changes in condition are reported to the medical technician, who will call paramedics in case of serious injuries. However, a confidential witness stated they were not informed of the resident's change in condition. Additional information indicated that the medical technician calls families and responsible parties whenever there is an incident or a change in condition. It was alleged that Facility staff left residents in urine-soaked clothing for an extended period of time. Concerns were made about staff not attending residents briefs in a timely manner. LPA interviewed multiple staff and residents, and information obtained revealed residents are being changed every 2 hours or sooner depending on the residents’ needs. Interviews obtained from 2 of 3 residents corroborated that residents are not left alone in their urine. It was alleged that Facility staff impeding on third party's investigation. Concerns were raised about facility staff refused to provide requested documentation to the Ombudsman. LPA conducted interviews with facility staff, and they do not recall documents requested by the Ombudsman. LPA attempted to contact the confidential witness for additional information but did not receive any information. Based on observations, interviews, and records review, the allegations listed above are unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of this report was provided to Executive Director Teressa Mapilis