Follow-up·November 12, 2025

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and also conducted this case management inspection. LPA met with Administrator, Victor Burachek, and explained purpose of inspection. Also present was staff, Natalia Burachek. LPA and Administrator discussed the passing of resident (R1) on November 11, 2025. The Administrator stated he and (R1) attended a video appointment on Wednesday, November 5, 2025 in the morning, with a Nurse Practitioner, who recommended (R1) go to the hospital immediately due to hallucinations and nightmares and sleep disturbances, but (R1) refused. The next day a nurse called the Administrator from the doctor's office to tell the Administrator he agreed with the Nurse practitioner and (R1) should go to the hospital. The administrator stated he felt (R1) needed some medication related to sleep, but the doctor said he wanted to see (R1) in person, which (R1) and the Administrator attended on Monday, November 10, 2025, in the morning. At the appointment, the doctor discontinued (2) medications, increased (1) medication and added (1) new medication. The Administrator gave the medication that was increased later that evening, and the new medications arrived the following morning, after (R1) left to the Emergency Room. The Administrator stated on the morning of November 11, 2025, (R1) was found to have low blood pressure and an unusual bowel movement. There was no fever and oxygen level was excellent. The administrator later learned on November 11, 2025 that (R1's) body was not accepting medical treatment from the Intensive Care Unit (ICU) and (R1) passed around 5:00 pm, due to internal bleeding, which the Administrator was told (R1) had a history of. LPA obtained documentation showing the medication changes made on November 10 and the last physician's report. Since (R1) was not under hospice care, the Administrator will request a death certificate and provide it to the Department when available. There are no deficiencies issued in this report.