complaint·February 7, 2022

party and makes their own decisions. R1 regularly refused care, including incontinence care, hygiene assistance, and assistance with Activities of Daily Living (ADLs.) On the day of the incident, staff noticed R1 required medical attention, but R1 refused care. R1 continued to refuse care, but eventually agreed when R1's family member was called and spoke with R1. All 4 of 4 residents interviewed all indicated that the facility assists with medical concerns in a timely manner. Based on interviews and record review, there is insufficient evidence to support the allegation; therefore, the allegation that "facility staff failed to seek timely medical attention for resident" is deemed UNSUBSTANTIATED at this time. Staff interviews revealed that residents are assisted regularly throughout the day and as needed with their incontinence needs. Residents are regularly assisted with showers between 3-4 times per week. Staff assist residents daily with all other ADLs. Interviews revealed that R1 regularly refused care and that R1's family member would convince and offer incentives to R1 to allow staff to assist with hygiene needs. Other pertinent parties indicated even prior to residing at this facility, R1 would refuse to take care of their own hygiene needs and refuse assistance as well. Documents reviewed corroborated R1's refusal of assistance with hygiene needs. Based on interviews and record review, there is insufficient evidence to support the allegation; therefore, the allegation that " Facility staff failed to assist resident with hygiene needs" is deemed UNSUBSTANTIATED at this time. During facility tour, LPA Dulek did not notice any areas contain unpleasant odors. Interviews revealed that although facility house rules prohibit smoking indoors, some residents, including R1 have been caught smoking inside resident rooms or residents open their doors and smoke just outside their rooms at times. Some residents indicated that previously the facility had an unpleasant odor, but it has been a number of years since this was a concern. Based on interviews and observation, there is insufficient evidence to prove the allegation; therefore, the allegation that "Licensee failed to maintain facility odor free" is deemed UNSUBSTANTIATED at this time. Exit interview was conducted with Administrator Becky Spring. Report was provided via email.