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32 | Continued from 9099
LPA’s interview with R1’s Private Caregiver 1 (PC1), revealed they assisted R1 with bathing, grooming and dressing at the facility at least twice a week. Interviews further revealed PC1 had never observed any wounds or bruising on R1 while R1 was in care at the facility. LPA interview with Administrator and staff along with records review of R1’s file revealed there was never an observation of wounds or bruising on any part of R1’s body. LPA was unable to obtain additional information from reporting party regarding this allegation. Based on information gathered during this and previous visits, the department does not have sufficient evidence to determine that R1 was ever observed with wounds and bruising. Therefore, the allegation that resident sustained injuries while in care has been deemed UNSUBSTANTIATED at this time.
It was reported that Staff did not ensure resident was seen by a physician, as it was alleged that R1 had not been to a doctor in over a year. LPA records review of R1’s file revealed, that according to physician’s reported dated 08/14/2018, R1 had the following diagnoses and health conditions, COPD exacerbation, blindness, Non-Ambulatory, able to communicate needs, follow instructions and needed some assistance with self-care. File review further revealed there was nothing notated in the change of R1’s health condition upon admittance that would require Licensee to conduct a reappraisal. LPA interview with PC1 and staff, revealed PC1 drove R1 to doctor’s appointments multiple times throughout R1’s stay in the facility. LPA was unable to obtain additional information from reporting party regarding this allegation. Based on information gathered during this and previous visits, the department does not have sufficient evidence to determine that R1 had not been to a doctor in over a year. Therefore, the allegation that staff did not ensure resident was seen by a physician has been deemed UNSUBSTANTIATED at this time.
It was reported that staff did not administer resident’s medication, as it was alleged that staff were not aware of what two (2) medications R1 needed to take. LPA records review of R1’s file and most current centrally stored medication log revealed that prescription Quetiapine Fumarate 25mg, quantity 90 was prescribed to be taken once nightly. The prescription Trazadone 50mg quantity 45 was prescribed for R1 to take ½ a tab at bedtime. No Medication Administration Record on file for LPA to review. LPA interview with PC1 revealed PC1 did not express any concerns of R1 not being administered medication while in care. Interview further revealed PC1 has observed staff administer medications to R1 on multiple occasions. LPA’s interview with family member / responsible parties of residents in care revealed that each were satisfied with the services of the facility staff and each did not express any immediate or potential concerns of staff not being aware of what medications to administer to the residents in care.
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