complaint·October 17, 2023

**Report continued from 9099..... Allegation- Staff are not following a licensed physician's order for a resident. Unsubstantiated. The department conducted interviews with staff, record review and facility observations to investigate this allegation. From record review and interviews, it has been found out that R1 had unwitnessed fall on 09/24/23 and facility sent out R1 to hospital to seek medical treatment after that fall incident. R1 sustained a neck fracture due to the fall and came back to the facility on 09/29/23 and had order to put neck brace on however there were no specific instructions as to how many hours per day the R1 must wear neck brace. Based on interviews conducted, it was learned that R1 did not like the neck brace and did not want to wear it. R1 was seen by occupational therapy (OT) on 10/02/23 who advised facility staff that R1 needs to wear their neck brace at all times, even during meals however staff can loosen it or can leave paper towel in between so R1 can enjoy the meals. Facility staff reported that R1 has poor food intake due to neck brace and R1 not wanting to wear neck brace. Additionally, facility clarified with R1s doctor and therapy regarding this issue and following the doctor’s orders for R1. Based on all this information, this allegation is Unsubstantiated. A finding that the complaint allegations is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit meeting conducted. A copy of this report has been provided to facility.