It was alleged that the facility has one preferred hospice provider and residents are not able to choose another provider. LPA reviewed documents for the fifteen (15) residents on hospice. At this time, there are four (4) different hospice care providers contracted to provide hospice care for the residents. Interview revealed that previous residents also used different providers, but at this time there are no residents using these other providers. Additionally, there are two (2) different companies providing home health services to two (2) residents in care. In total, LPA reviewed documentation of six (6) different outside agency providers. Interview with staff revealed that residents and their families choose which agency provides care to the resident. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “staff do not dispense medications as prescribed:”

The complaint alleges that residents requiring a PRN (as needed) medication are required to wait for the medication to be administered until their medical provider is contacted. Interview with staff and management revealed that all residents do have a PRN authorization form on file signed by their individual medical provider. This form allows the medical provider to indicate whether the resident is able to determine their own need for a PRN medication, whether they can clearly communicate signs and symptoms related to the PRN medication, or whether the resident cannot determine their need for a PRN medication or communicate their symptoms. Based on the resident’s determined PRN status, the facility handles PRN medications differently, which is required in Title 22 regulations. Staff interviewed stated there are some residents in the facility who cannot determine their need for a PRN medication. For these residents, the medication technicians do reach out to these residents’ medical providers, whether a primary care physician or their hospice medical professionals, to allow the medical provider to determine whether PRN medication administration is appropriate at that time. Per Title 22 regulation for Residential Care Facilities for the Elderly, trained medication technicians are only permitted to assist with the self-administration of medications. When the resident cannot determine their own need for PRN medication, nor can they communicate their symptoms, regulation states that the facility staff must

Report Continued on LIC 9099-C

No deficiencies observed during today's visit. Exit interview conducted and report issued.