Complaint·November 5, 2021

A total of three (3) staff were in the apartment of the residents (R1 & R2) providing needed evening care to R2. During staff providing care to R2 an incident between staff 3 and R1 was reported by both the resident and by staff 3. R1 reported that staff person was violating their personal rights and being abusive. Staff denied any pushing of the resident or the walker, yelling, speaking loud or rude to R1 or any residents at any time. The allegation of the resident was treated inappropriately, was found to include an allegation of the resident was not properly reassessed, was determined to have been previously investigated-see complaint report dated 4/20/2021. The Department LPA reviewed information provided by the reporting party(s). The LPA reviewed resident records (R1), including care plans, re-assessment(s), incidents, medical records/ documentation. The LPA reviewed records, and conducted interviews with staff, and other related party(s). The investigation revealed there was a reassessment done on 9/28/2020 by S3; S3 also observed care staff providing services to R1 in residents home, and the responsible party of R1 was present at the time. Per S1 the responsible party had input regarding R1's care needs, and per S1 these were incorporated into the resident's care plan, in the instructions portion. S1 stated a new reassessment started 9/28/20 and was completed 10/2/20 by S3, an RN staff of Varenna. S3 stated R1 has had additional decline due to the diagnosis of Parkinson's, and a reassessment was needed to provide current care needs to R1; Per record review and interviews, S3 reviewed medical documentation, current care plan, resident incidents, observation of care being provided to R1. S3 stated they took into consideration input from R1's responsible party on 9/28/20 during the assessment of R1. S3 used the worksheet tool, points system on care needs of the resident, and from this an updated care plan is created. Per interview with S1, and records review, the reassessment documents were provided to the responsible party (RP) on 10/2/2020, delivered by staff to the RP in a sealed envelope. Per review of a letter dated 10/2/2020, summary of the letter stated to the RP that to please notify administration staff of any family member and/or health care professional(s) that RP would like included in a care conference being set-up to discuss the new care plan and reassessment documentation with RP. Per S1, they had discussed with RP on 10/5/20 that the care conference would be a time to review and discuss the reassessment and care plan, and that RP could have someone/others there, a family member, Physician of the resident, other health care professional but at that time the RP told S1 that they would provide information at a later date. S1 stated to the LPA that no information was provided by RP to S1 or any other staff person of RP's family member or health care professional RP would like to be included and/or notified of the care conference. Per record reviews, LPA observed a reassessment document, worksheet tool, and the service plan from the reassessment started on 9/28/20, and completed 10/2/20 by S3, an RN. LPA also interviewed reporting party (RP); Reporting party gave conflicting information to the information obtained from other parties during the investigation. RP does not agree with the reassessment that was done, the increased care needs and services, and the increased fees that were noted in documents received on 10/2/2020. Investigation identified that resident’s reassessments were reviewed, and when there were increased needs these may result in increased fees for additional services. There was discussion back and forth between party(s) regarding the increase care service fees. Investigation also showed that reassessments were completed using the appropriate procedures and documentation per facility policies, and financial documentation shows care fees were being paid for care services, including increased fees. Per review of financial payment account records when there was an overpay of care fees the fees were credited to the responsible party as required. Based on the Departments investigation, interviews, file reviews, and conflicting information obtained during interviews with other related parties there is insufficient information to prove or disprove the allegations of staff spoke to the resident rudely and loud, staff pushed resident's walker while resident was using it and resident almost lost their balance, and resident was not properly reassessed. Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. No deficiencies and/or citations issued today. Exit interview conducted with Ferdinand Buot and Deborah Smith