complaint·December 15, 2022

Three hospice care staff were interviewed. Based on the interviews, R1 was being visited by Hospice between three to five times a week. When asked a routine question on the status of the resident’s condition, facility staff stated R1 would eat almost 100% of all their meals. R1 had a behavior in opening their mouth constantly, regardless if food or drinks were offered. It was undetermined whether this was related to R1’s medical diagnosis or hunger. When given water during a hospice care visit, R1 observed to finished two full glasses and appeared to be thirsty. According to the interviews, there was no indication that facility staff had neglected R1 or refused to provide food or fluids to R1. Based on record review, R1 was dependent for all Activities of Daily Living (ADLs). R1 was being administered multiple medications in which one of side effects may be constipation. Throughout December 2021, R1’s main medical concern was constipation with no mentions or signs of dehydration. In January 2021, notes indicated that R1 was eating well. R1’s doctor instructed facility staff to encourage fluids daily as tolerated to promote bowel movement. In January 2021, there was no mention of R1 showing signs of dehydration. Given R1’s medical diagnosis, R1 remained at risk for multiple medical issues which included dehydration. Based on record review, a home health aide (HHA) from the hospice agency informed staff that prior to the hospice nurse visiting R1, HHA had also offered fluids and applesauce but R1 refused and spit it out. The Department has investigated the above allegation. Based on interviews and record review the Department has determined that the above allegation is UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Executive Director, Jolie Higgins and a copy of the report was provided.