complaint·October 25, 2022

9099A(C)(1).. Allegation: Staff placed a soiled diaper in a resident's face. Complaint alleges that staff placed a soiled diaper in resident's face when assisting her in the bathroom. Interviews with staff and Administrator/managers revealed that no care staff would place a soiled diaper in a resident's face. Lead caregiver stated she was at the facility on Sunday, 8/21/22 when the sheriff conducted a wellness check on R1, and stated the Sheriff stated he didn't see any concerns with care or supervision. Additionally, the Ombudsman visited R1 just after the Sheriff's visit and indicated he didn't see any issue with R1's care, but requested staff document any unusual or recurring incidences. Lead care staff was not aware of staff allegedly putting a soiled diaper in R1's face until the Sheriff's came out on 8/21/22. Also, Lead care staff did not hear R1 mention anything about staff placing a soiled diaper in her face but did her complain about the diaper being thrown at her in a bag. LPA also heard R1 discuss the diaper being thrown and did not hear R1 mention anything about a soiled diaper being placed near her face. Based on information obtained, LPA finds the allegation to be UNFOUNDED. Allegation: Staff do not provide adequate food service. Complaint alleges that resident is served soup when she does not eat soup and when she requests a sandwich, she is told they do not have peanut butter. R1 stated she "doesn't want soup and a half sandwich" and she likes peanut butter and jelly sandwiches and "sometimes staff will give her that". All staff interviewed stated that if a resident doesn't like the menu item served, staff will prepare an alternative dish for the resident. LPA observed the facility to have sufficient food, including peanut butter and jelly, on 8/26/22 and again on 10/25/22. (3) other residents interviewed stated that there are no concerns with the food service with (1) resident stating that the food is served in "small portions that are not proportionate". Based on information obtained, LPA finds the allegation to be UNFOUNDED. Allegation: Staff are not providing comfortable accommodations to a resident. Complaint alleges R1 feels dogs are treated better than she is, staff gather in the area outside of her door and speak loudly to each other, and sometimes early in the morning, staff wake her up early and take her to the table before breakfast preparations have started. cont on 9099A(C)(2)... 9099A(C)(2)... (4) other residents interviewed stated they receive very good care and receive assistance when it's requested. Residents stated staff will wake them up and give them a bed bath before taking them to the dining area at 8:30 when breakfast is served. Staff interviews revealed that starting at 7:00 am, all residents get a sponge bath and their hair combed to prepare them for breakfast which is served at 8:30 am. Lead caregiver stated that staff will wake R1 up in the morning around 7:00 and R1 will do her own hair and is ready around 8:10 am every morning, but will wait in her room until breakfast is served at 8:30 am. Lead caregiver stated she has never heard R1 say that she is "treated worse than a dog". Lead care giver stated that staff will talk loudly only so resident can hear better and also due to the caregiver's accent so it is clearer to understand. Also, the television nearby is often turned on which could be adding to the noise level. Based on information obtained, LPA finds the allegation to be UNFOUNDED. Based on information obtained, LPA finds the above (4) allegations to be UNFOUNDED - meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview. Copy of report left at facility. Allegation: Staff threw an item at a resident while in care Complaint alleges that resident placed the soiled diaper in a bag after being assisted in the bathroom by staff, placed the bag by the door of her room, and then the staff member then threw the bag at her. Physician's report dated 3/5/22 notes resident (R1) has a diagnosis of Dementia, can be confused or disoriented, can follow simple instructions and communicate needs and needs assistance with toileting and/or using incontinent products. Physician's report and interviews confirmed R1 has a visual impairment and is considered legally blind. Lead caregiver stated that R1 is "very independent and is doing well". R1 was interviewed on 8/26/22 stated she is not sure which night shift staff it was but recently a staff threw a diaper in a bag at her. R1 stated the bag didn't hit or hurt her and "the lady that threw the diaper might not work at the facility anymore". Facility staff interviewed stated that R1 is capable of taking her diaper off but needs assistance also with toileting and staff will ask her to call for assistance, never requesting she put a soiled diaper in a bag by the door. Lead caregiver stated she observed a tied bag containing a diaper that was found inside R1's door prior on/around 8/21/22 when the incident allegedly occurred and was reported to local authorities. A copy of the sheriff report was not available. LPA was unable to interview any NOC shift staff and another staff (S1) was no longer working at the facility. Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview. Copy of report left at the facility.