complaint·October 14, 2022

LPA requested S1 put on a mask during the visit and S1 stated, “Ha’ha.’” On 10/06/2022, LPA was asked to sign in. Licensee was unable to provide sign-in and screening records from January 2022. Based on interviews and documentation, the allegation of, “Staff are not following COVID-19 guidelines” is substantiated at this time. Technical Assistance is issued in lieu of a citation. Exit interview, report singed, and report emailed. There were also no notes expressing concerns about the soiled diaper. Interview with S1 indicated that R1 was changed as needed and checked regularly throughout the day. Based on interviews, and documentation there is not enough evidence at this time to support the allegation of, “Resident left in a soiled diaper resulting in resident sustaining a rash.” and is unsubstantiated at this time. As to the allegation of, “Resident’s medications are not properly stored.” LPA visited the facility at 10:30am on 10/03/2022 and conducted an unannounced facility visit and tour of the facility. During that facility tour, LPA observed facility medication was secured in the living room/kitchen room area in a locked storage cabinet and securely locked with a padlock. Additionally, there is a small refrigerator in a facility closet that was also observed by the LPA to be securely locked with a padlock. In an interview at 3:30pm on 10/04/2022, P1 stated that facility staff did not show P1, P2 or P3 where the medication was being stored, P1 did not recall the conversation, only feeling uncomfortable about the storage of the medication. In an interview with S1 at 11:15am on 10/03/2022, when LPA asked about medication storage and hospice medication and training, S1 stated that they had been doing this (hospice medication training) for 32 years.” On 10/06/2022, S1 provided documentation from VNA Health dated 08/12/2020 of certified hospice training for -Turning, -Incontinence Care to Prevent Skin Breakdown, -Proper Hydration, -Infection Control and -Pain and Symptom Management, with S1, S2 and S3 noted on that training. Based on observations of the medication storage being secure and interviews at this time there is not enough evidence to support the allegation of, “Resident’s medications are not properly stored. and is unsubstantiated at this time. As to the allegation of, “Staff left residents unattended.” It was discovered through interviews and documentation that interview conducted at 3:30pm on 10/04/2022, P1 stated that on one of their visits to the facility the only caregiver went to the house next door and left R1 alone with P1 in the facility for an unknown amount of time. P1 stated that visits are about an hour depending on condition of the patient. LPA reviewed physician’s reports for the three residents who lived in the facility at the time. Only R1 needed supervision by staff. During this incident, R1 was with P1 in a private medical appointment at the time the staff went to the facility located next door for an undisclosed amount of time. Based on interview and record review, the allegation of, “Staff left resident unattended” and is unsubstantiated at this time. Technical Advisory is issued that facility staff should always be present at the facility and available to residents. CONTINUED on LIC9099-C As to the allegation of, “Staff are not properly trained.” It was discovered through interviews and documentation that on the interview conducted at 3:30pm on 10/04/2022, P1 stated that the staff at the facility did not communicate that they were trained in hospice care or hospice medication management. P1 also stated that they did pre-draw oral syringes for hospice medications and provided the predawn syringes to S1 for R1’s hospice medication needs. In an interview at 11:15am, on 10/03/2022, when LPA requested documentation for hospice care training and hospice medication training, S1 stated that, “I’ve been doing this for 32 years, I am sure I have something.” On 10/06/2022, S1 provided documentation from VNA Health dated 08/12/2020 of certified training for -Turning, -Incontinence Care to Prevent Skin Breakdown, -Proper Hydration, -Infection Control and -Pain and Symptom Management, with S1, S2 and S3 noted on that training. This training met the training requirement for hospice services. Based on interviews and documentation there is not enough evidence at this time to support the allegation of, “Staff are not properly trained.” is unsubstantiated at this time. Exit interview, report signed, and report emailed.