Complaint·October 29, 2021

On 09/01/2021, the Department interviewed 6 facility staff (S1-S6), 3 residents (R1-R3) and R1’s family member. 6 Out of 6 staff stated R1 has sensitive and fragile skin that is easy to tear or cause bruises. 3 Out of 6 staff stated R1 has behavior of scratching, and flailing R1's arms, and maybe due the friction from changing R1’s clothes, blankets rubbing against R1's skin. All 6 staff denied allegation that R1 was physically abused by staff and they do not know how or what was the cause of the R1's skin tear and bruises though they speculate that R1's skin tear and bruises may have been caused from scratching R1’s self. They placed pillows and paddings around R1 and bed rails to prevent R1 from injury. All 6 staff stated that R1 has unpredictable behavior. When R1 gets agitated when ADLs are being provided, R1 will flails arms around and hits R1’s bed railings or chair arms. Staff also stated that R1 will made comments that staff are trying to poison R1 when being assisted with medication. On 09/01/2021, the Department interviewed 3 residents, 2 Out 3 residents (R1-R2) did not speak or non-responsive while R3 loves living at the facility. R3 does not even feel scared or uncomfortable with staff. On 09/08/2021, the Department interviewed R1’s family member (FM). FM stated that R1 has a frail skin. FM also witnessed R1 made comments about staff trying to hurt R1 or yell that R1 does not want to be touched. FM is aware that R1 is sometimes difficult to take care of because R1 will try to pull arms away when touched. R1. FM believes the bruises are caused from staff moving and adjusting R1 when the staff need to reposition R1. FM stated the staff places the pillow around R1 to prevent R1 from bruising, but there is not a lot of meat between R1's skin that caused R1's bruises. FM does not believe staff are intentionally hurting R1. Page 2 of 3. See continuation page 3 of 3. Based on the records reviewed, R1 has history of skin tears and R1 has behaviors of aggressive agitation and behavior of arm flailing. The Department has investigated the above allegation. Based on the investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. No citations noted at today’s compliant investigation visit. Exit interview was conducted with Administrator. This report was provided to ADM for signature. A copy of this report was emailed to ADM. Page 3 of 3.