complaint·February 18, 2026

Allegation: Staff do not ensure that resident's incontinence care needs are met-Unfounded LPA conducted interviews with staff and residents. Residents who are incontinent are checked frequently throughout the staff shifts. Staff indicated they check on residents about every two (2) to three (3) hours or more frequently if needed. Interviews revealed they have a resident who uses a colostomy bag. Interviews revealed the resident is able to empty it on their own but will sometimes need assistances as well as reminders. Allegation: Staff handled resident in a rough manner, resulting in resident sustaining an injury- Unfounded Interview with Health and Wellness Director (HWD) revealed that there was an incident with Resident #3 (R3) had a choking incident. HWD was called to the dining area R3 was blue and not making any noise. HWD attempted the Heimlich but was unsuccessful as the resident is bigger and in a wheelchair. With the assistances of other staff R3 was brought down to the carpet where HWD was successful with black blows. Due to being on the carpet R3 did get rug burn on their face. The food was dislodged. R3 is now on purees as they have been having difficulty with swallowing food. Interview with staff revealed that they do not believe HWD handled the resident roughly. The facility sent resident out to the hospital and returned with new puree diet orders. Allegation: Staff do not observe residents for change in condition- Unfounded Interviews with staff revealed they all follow/ know the same processes. Staff indicated when staff notice a change in a resident’s condition, they are to notify the med tech. The med tech will then notify HWD. If the resident is on hospice, hospice is notified. Additionally, staff indicate they contact the resident’s physician and responsible party. Allegation: Staff do not serve residents food of good quality-Unfounded Interviews with residents revealed that residents do like the food. Interviews with staff revealed that some residents have different food than others. It depends on the type of diet they are on. Some residents need a soft food diet and others need a puree diet. **continued on 9099-C2 Allegation: Staff inappropriately spoke to resident- Unfounded LPA conducted interviews with staff and residents. Resident #2 (R2) does have an animal that lives with them at the facility. It was part of R2s stipulation with family and facility if they were going to be residing at the facility. R2 was out with their animal, got tangled up with the leash and had a fall. R2 was then taken to see the HWD. HWD asked R2 if they were hurt anywhere and R2 responded no. HWD said they looked at R2 and then R2 just responded with "I am not getting rid of the dog." The response from R2 made HWD laugh when R2 said this. It was observed that R2 has a sense of humor. Interview with residents revealed they have good experience with staff. Based on information obtained through interviews, the Department finds the allegations to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of the report was left at the facility.