Follow-up on corrections·January 28, 2025

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to follow up on a complaint investigation, but observed an unrelated deficiency to be addressed in this case management report. LPA Moleski met with facility administrator Danielle Barry and explained the purpose of the visit. LPA Moleski attempted to interview a resident (R1) in their room, and observed R1 lying in bed, rocking back and forth, and chewing and sucking on large off-white padded mittens wrapped onto R1's wrists. R1 was not able to verbally respond to LPA Moleski. In an interview, Barry said that R1 came back from a recent hospital visit with the mittens, which were meant to prevent R1 from biting and sucking on their own hands. In an interview, the facility's memory care director (S1) said R1 returned to this facility from a hospital visit on 1/13/25 with the mittens. S1 said that R1's conservator has authorized the use of the mittens. LPA Moleski asked for physician's orders for the use of the mittens. S1 said there were no physician's orders on file for the mittens. 22 CCR Section 87608(a)(3) states that "a written order from a physician indicating the need for the postural support shall be maintained in the resident’s record" and that "the licensing agency shall be authorized to require other additional documentation if needed to verify the order." However, 22 CCR Section 87608(a)(5) indicates that "under no circumstances shall postural supports include ... depriving, or limiting the use of a resident's hands..." LPA Moleski asked S1 if R1 was able to remove the padded mittens independently. S1 said that R1 has on occasion been able to remove the mittens by using their mouth to remove the fastener holding the bindings in place. 22 CCR Section 87608(a)(2) states that "postural supports shall be fastened or tied in a manner that permits quick release by the resident." This facility is hereby cited per 22 CCR Section 87608(a)(5). If this facility wishes to use these sorts of devices in the future, the facility administrator should provide a physician's order, written consent from the resident and/or responsible parties, and a written request for an exception to the facility's assigned LPA. An exit interview was held with Barry. Appeal rights and a copy of this report were left with Barry.