Complaint·April 5, 2023

The facility has a visitor sign-in log. The administrator explained they did not review the visitor log, as they followed the guidelines of notifying the responsible party and R1’s physician. The Mitigation Plan and Provider Notification Information (PIN) 22-04 ASC indicated to document the individual’s name and contact information upon entering the facility for possible contact tracing. The Mitigation Plan and/or PIN does not have a requirement for contact tracing. There was no indication R1 was positive with Covid-19 on 06/27/22 as there were no present symptoms when the family member visited. Outside source interviews confirmed R1’s family member that visited R1 did not contract the virus and was not in danger. The facility uses the required Identification and Emergency Notification (IEN) form which identifies the responsible party. A review of R1’s IEN indicated R1’s responsible party was listed and there were no family members listed. The administrator followed the Covid-19 guidelines by notifying the appropriate parties outlined in their Mitigation Plan. During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation is deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Business Manager, Monica Cordoba whose signature below confirms receipt of these rights.