Incident investigation·September 23, 2021

Licensing Program Analysts (LPA's) A. Canela and Lopez conducted an unannounced case management inspection and met with Outreach Coordinator/Assistant administrator, Emily Doran. The purpose of this case management inspection is to follow up and obtain additional information on an SOC 341 that was received by outside agency and a self reported incident report that was submitted by the facility to Community Care Licensing (CCL) that occurred on 8/15/2020. LPAs acquired documentation and reviewed resident R1s records regarding the incident, in which it was reported resident R1 was sent to emergency department on 8/15/2021. It was reported R1 was found on the floor of her bathroom (unwitnessed fall). R1 claimed she was pushed onto the floor by a staff. Facility administrator was not in the facility and LPAs were not able to confirm if an internal investigation was conducted. LPAs reviewed residents file in which it was documented resident transitioned into their memory care unit from the assisted living unit after R1 was noted to have more anxiety, and agitation. LPAs will review additional information that was requested from facility. LPAs consulted with facility regarding Covid-19 infection control protocols and went over Provider Informational Notice (PIN) 21-41-ASC. No deficiencies cited during todays visit.