complaint·May 2, 2025

LIC 9099-C Allegation: Staff left resident unattended for an extended period of time resulting in hospitalization. File review of R1's medication order on March 13, 2024, it revealed R1 has a previous medical history of hypertension and CKD (chronic kidney disease) stage G3b/A1. Incident report submitted for R1 revealed R1 was sent to the hospital for evaluation due to discoloration around mouth and high temperature. File review of R1's hospital discharge document, it revealed R1 was treated fro acute kidney injury. Document stated the cause of injury may be due to "heart and blood vessel disease". Based on information gathered from R1's physician report it revealed R1 has a primary diagnosis of dementia and secondary diagnosis of atrial fibrillation. Interview conducted with Health and Wellness Director revealed residents in care are checked during rounds every two hours. Health and Wellness Director denied any observation of sunburns on R1. Therefore, allegation is unfounded. Allegation: Staff are not meeting residents needs The Department conducted extensive file reviews for the following allegation. File review of R2's care plan conducted on February 22, 2024 revealed R2 is a "one to two" person assist with transfer. File review of R2's care plan conducted on June 13, 2024 revealed R2's level of care has changed which R2 is now a two person assist with mechanical lift. Interview with Health and Wellness Director revealed hospice agency has trained fcaility staff how to use mechanical lift. For new staff, Health and Wellness Director then train staff through demonstration. File review of staff training revealed training was completed by Health and Wellness Director and Suncrest Hospice regarding Safe Transfer with Hoyer Lift, with approximately 17 staff present in attendance. Therefore, allegation is unfounded. Based on information obtained, the following allegations of: Staff left resident unattended for an extended period of time resulting in hospitalization, and Staff are not meeting residents needs, are UNFOUNDED. Unfounded meaning that the allegations were false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of the report was provided.