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A review of facility and medical records indicated that on August 28, 2023, R1 tripped on carpet and fell in their apartment. R1 received immediate medical attention and was transported to the hospital by emergency personnel. A review of R1’s medical reports indicated that R1 sustained a severe thumb fracture. R1 was admitted to the hospital for orthopedic hand surgery and was placed into a thumb spica splint. The medical report indicated that R1 showed behaviors with elements of paranoia and dementia. On August 30, 2023, according to the medical report, R1 was discharged with non-weight-bearing instructions on the right thumb and to keep the dressings and splint clean, dry, and intact. A review of the care conference report that took place before discharge with R1, R1's responsible party, and the assigned care manager stated that R1 would require 7/24 care in their independent living apartment after rehabilitation services were provided in skilled nursing aka “Care Center” located in the community. During the care conference, R1 was informed of what was required for them to be discharged back to their independent living apartment when there was a change in condition. Facility management informed R1, as stated in the admissions agreement signed on January 18, 2021, that they would need to have 24-hour caregivers and adhere to the safety precautions required to be in place due to R1’s fall risk condition and cognitive status. Facility management also informed R1 of the option to move out of the facility to another community and that a list of facilities would be provided to assist with finding another community. R1 and R1’s responsible party declined the moving out option and opted for R1 to stay at the care center until further medical evaluations were completed to establish if R1 could return to independent living. During interviews with facility staff, it was indicated that R1 and R1’s responsible party were offered a copy of the "resident rights" but declined acceptance. An interview with R1 confirmed their understanding of their care service plan while living in the care center. In addition, during an interview, R1 confirmed that the facility would hold their apartment while they remained in the care center and that they could access their apartment as needed to obtain any necessary items as long as they were assisted by facility staff. During the investigation, it was determined that the R1 entered into a continuing care residency agreement at the community on January 18.2021. The agreement stipulated that upon transfer to the care center after a hospital stay, the monthly fee would continue to apply if the resident intended to return to the apartment.
Continue at LIC9099C |