complaint·October 28, 2022

Emergency Service Personnel interviews revealed that when a resident refuses they usually perform a cognition test and if the patient is cognitive and refuses to go to the Hospital, they provide the resident with a release form for liability and it is against patient’s rights to force them to leave. Emergency Personnel stated the Wellness Director made emergency personnel take R1 to the hospital even though they didn’t feel R1 had to go and R1 refused. LPA informed Wellness Director that the facility cannot force the resident to go to the hospital. Wellness Director stated the staff are not trained and unable to monitor the resident for a change of condition and they cannot put that kind of pressure on the staff in case the resident has a brain bleed and passes out or passes away later. LPA informed Wellness Director that the facility should seek medical attention by calling 9-1-1 and have the resident assessed by Emergency Medical Personnel. Based on the assessment done by Emergency Medical Personnel and the resident and/or Power of Attorney’s (POA) decision, the resident may refuse to be transported. LPA explained usually the Emergency Medical Personnel will have the resident sign a waiver that explains refusing medical services. LPA explained residents have the right to refuse medical care, the same way they have the right to refuse other care. Based on interviews this allegation is deemed Substantiated at this time. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D) Exit interview conducted. Report and Appeal Rights issued via email. There is insufficient evidence to substantiate this allegation, therefore the allegation is deemed unsubstantiated at this time. However, LPA recommends the facility ensure staff are aware of the powers a resident’s POA has to mitigate potential issues, and advises the Wellness Director to relate accurate information to Emergency Medical Personnel. On the allegation: Facility did not provide emergency information timely to emergency medical personnel. It was alleged that the facility takes a long time provide resident information to Emergency Personnel. Interviews revealed that after MedTech’s call 9-1-1, they must go to the med room, find the residents emergency binder, make a copy of the Emergency contact and Physicians report then look up their most recent Medication list and print it. Most staff stated this process is lengthy and they have suggested to management many times to make it more streamlined and timely. Interviews with Wellness Coordinator and Wellness Director stated they don’t have the med list preprinted because it changes often and after some practice the MedTech’s should be able to gather the documents in 5 minutes or less. One staff interview revealed that sometimes the binders are unorganized, in the wrong place and they are unable to provide Emergency Personnel with resident records. The staff was unable to provide specific details about when they were unable to provide medical records to emergency responders. LPA observed the resident record room was cluttered with papers and observed resident binders not in their designated spots. Based on observation and interviews, there was insufficient evidence to prove information was not provided timely to emergency medical personnel, therefore the allegation is deemed unsubstantiated at this time. However, LPA recommends the facility streamline their process for gathering emergency information for first responders, and recommends the record room be more organized. Exit interview conducted, copy of the report emailed to Administrator.