Complaint·November 27, 2023

R1, R2, and R5, confirmed that they or their family members order their medications. R9 said that R9 had run out of a medication. LPA Moleski reviewed eight months’ worth of MARs for R9 and did not observe that R9 had run out of this medication at any point since starting it, according to the MARs. During interviews, all four medication technicians (S7, S8, S9, S10) said there were no issues with staff ordering medications. During a visit on 11/14/23, LPA Moleski observed staff count out all narcotic medications. LPA Moleski observed an accurate count and did not observe any irregularities. During interviews, all four medication technicians (S7, S8, S9, S10) said there were no issues with the narcotic count that were not otherwise accounted for. During a visit on 11/27/23, LPA Moleski observed portions of lunchtime and dinnertime meal preparation. LPA Moleski observed staff taking appropriate hygienic measures, including glove use. During interviews, all four kitchen staff (S3, S4, S11, S12) described proper hygiene procedures. During interviews, residents did not voice concerns regarding hygienic procedures. LPA Moleski observed postings in the kitchen containing special dietary information and documentation of doctors’ orders for special dietary restrictions. During interviews, no staff members were aware of issues with regard to special dietary orders. During interviews, one resident (R10) said that R10’s dietary orders were not being followed. LPA Moleski observed R10’s correct dietary information posted conspicuously in the kitchen. The department has determined the following as it relates to the allegations that staff are not ordering resident's medication in a timely manner, staff do not wear gloves when preparing foods, residents are not provided adequate food service, and that staff mismanaged resident's narcotic medication: Based on interviews, observations, and record review, the above allegations are UNSUBSTANTIATED, which 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. No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Dunham.