Incident investigation·July 31, 2025

On 7/31/25, Licensing Program Analysts Sommer Hayes and Arvin Villanueva (LPAs) arrived unannounced at this facility to conduct a case management visit. LPAs met with Executive Director/Administrator Eric Hostetter (S1) and stated the purpose of the visit. Overview: The purpose of this visit is to follow up on an incident that was reported on 5/1/2025. A resident (R1) reported to facility staff that a staff member (S2) pushed R1; and R1 also mentioned having a bruise on their left forearm. Facility staff reported the incident to local law enforcement and the Ombudsman about the incident. Facility Action : S1 and the Memory Care Director (S3) conducted an internal investigation, which included reviewing the Fall Detection System in R1's room. The review showed that R1 went up to S2 and then fell onto the bed, and then onto the floor. The system also showed that S2 helped R1 get back up. It was noted that S2 was taken off the schedule after this incident. When S1 and S3 were interviewed during the visit, they stated that the police had reviewed the Fall Detection footage and had no concerns. They also mentioned that S2 had not returned to work since the incident. Based on today’s visit, no deficiencies were cited. Exit interview was conducted and a copy of this report was provided.