Follow-up·May 12, 2022

At approximately 1:00PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Other Visit, and met with Mikayla Muehleisen. The purpose of this Case Management Visit is to follow up on a self-reported incident and death report submitted to Community Care Licensing (CCL), to discuss Resident 2 (R2) phone calls to LPA, and to follow up with Facility regarding dining services. LPA spoke with Administrator regarding an incident and death report that was received by CCL on 4/1/2022. Incident report states that on 3/30/2022, Resident 1 (R1) was found on the floor by care staff, resident had a change in baseline, was hallucinating, and not making sense. Facility called 911 and Resident was sent to hospital to be evaluated. Facility notified responsible parties and physician. Resident returned to facility on the same day, 3/30/2022. Incident report states that facility was communicating with responsible parties and in the process of admitting resident to Hospice. Consult was scheduled for 3/30/2022 but was postponed due to resident's fall. Resident passed on 3/31/2022. Death report stated that on 3/31/2022, resident was found in bed by care staff not breathing. Facility notified responsible parties, Emergency Personnel, and Police. LPA requested Death Certificate regarding R1. LPA and Administrator discussed some voice mails that were received by LPA by Resident 2 (R2). Administrator to follow up with R2. LPA made observations of dining room to confirm if Facility is in compliance with corrective plans submitted to CCL. LPA and Administrator discussed moving serving/dining trays to the kitchen so it is accessible to Wait Staff but inaccessible to residents during dining hours. Serving/dining trays have been relocated. Dining Room is clear of serving/dining trays. No Deficiencies cited during this inspection.