Incident investigation·July 11, 2024

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to a recent incident report submitted to the Department. LPA met with Janeyn Kelly, Administrator, Jhamil Espino and Jacob Espino, caregivers, and explained purpose of inspection. LPA discussed the incident report when resident (R1) was out of the facility from 6/30/24 through 7/5/24, to spend time with relatives. When resident returned to the community on 7/5/24, staff noticed she was limping and had a slightly swollen right ankle. Resident stated her foot was bothering her starting on 7/6/24, after the Administrator asked if it was, but she could not recall how her ankle was injured, due to a diagnosis of Dementia. On 7/6/24, resident's family member visited and the situation was discussed at that time. The family member stated resident sometimes doesn't have good balance. The facility followed up and contacted the Advice Nurse initially, on 7/6/24, and has been applying ice compresses and elevating resident's foot, as recommended. The facility then reached out to the doctor on 7/9/24. LPA observed printed e-mail documentation where the physician recommended an x-ray to rule out a fracture and stated a prescription will be sent for an topical gel. LPA observed (R1) walking in sandals and appeared to not have a limp. Resident's ankle appeared slightly red and did not appear very swollen. Administrator contacted (2) family members during today's inspection and requested they confirm which family member will take (R1) to have an x-ray taken and evaluated soon. Also discussed, as reported, is that (R1) appears to be "pocketing" her medications they were recently found in her room. This was discussed with resident's family member and primary care physician, who indicated medications cannot be crushed at this time. Staff will continue to be present when (R1) takes medications and will try administering one tablet at a time. Administrator will follow up with the Department after an x-ray and evaluation are done. There are no deficiencies issued in this report. Exit interview. Copy of report left at the facility.