Staff say they made several attempts to shower R1 and clean R1’s apartment, and R1 refused on many occasions. They say they tried to change R1’s bed sheets, take R1’s laundry, and provide hygiene, and R1 only allowed them to do these things occasionally. Staff say R1 won’t use adult diapers, that R1 refuses and smells of urine. Staff say in the past 5 weeks, the resident has only allowed staff to give R1 one shower. Staff say they have gone to R1’s apartment, and R1 opened the door wearing a blouse, but no pants.

R1 says that staff try to give R1 showers and R1 refuses. R1 explains that they will only allow a female caregiver to help with showering.

LPA reviewed staff notes for 9/25/22 through 4/11/23. Notes show that R1 refused showers on 10/25/22, 3/6/23, and 3/26/23; refused medications on 10/21/22 and 2/8/23; and refused housekeeping on 10/19/22.

W1 says that on 3/16/23, R1’s doctor diagnosed R1 with dementia, and soon thereafter R1 moved to a memory care facility.

Staff attempted to provide basic care services to R1, but R1 refused. Staff reached out to R1’s responsible party in October 2022 to inform of these concerns, however, the responsible party did not follow-up. Based on evidence obtained, the allegation is deemed unsubstantiated at this time.

On the allegation, “Staff failed to keep facility clean and/or sanitary,” the complainant was concerned that R1’s apartment has a strong urine odor that lingers into the hallway. Complainant also says that R1’s apartment is very dirty with dishes, dirty laundry, and dirty underwear throughout the sink and shower as well as wet and dirty bed pads that R1 places in the bathroom.

LPA observed R1’s apartment which had clothing in the bathroom sink, a towel in the shower, and clothes, a box, and a bag on the floor in their bedroom, R1’s hair is long hanging down around their face a bit messy, and fingernails were approximately 1 inch long. There was no malodor in the apartment.

Continued on 9099-C.

Staff say that they observed R1’s apartment with undergarments in the bathroom sink, a soiled bed pad on the bed or floor, and the smell of urine. Staff say they have made several attempts to assist R1, but R1 refuses and does not let staff in their apartment. Staff also say they had to convince R1 to allow them in their room so staff could remove dirty laundry and clean the room.

Housekeeping staff say that R1 doesn’t allow staff to clean the room and when staff goes to R1’s apartment R1 tells staff to “come back.” Staff say they’re supposed to clean once a week and that sometimes the resident lets staff clean but sometimes R1 refuses. Staff also describes a situation where the resident was “screaming bad words and said don’t touch my things.” Staff says sometimes it takes a month before R1 allows staff entry to clean.

Staff reached out to R1’s responsible party in October 2022 to inform about these concerns, however, the responsible party did not follow-up.

LPA reviewed staff notes for 9/25/22 through 4/11/23. Notes show that R1 refused housekeeping on 10/19/22.

Based on the evidence obtained, the allegation is deemed unsubstantiated at this time. Staff did their due diligence in attempting to assist the resident and reached out to their responsible party when issues arose.

On the allegation, “Staff failed to provide adequate food service,” the complainant’s concern was that, in April 2023, staff served R1 ribs on the bone which could be a potential choking hazard for an older person.

LPA reviewed R1’s Physician Report (LIC 602) which shows a dietary restriction of “regular with cut up meals.” LPA observed a list of residents with special dietary needs, displayed in the kitchen. R1 is on the list, however, it does not state that R1’s meals should be cut up. LPA reviewed the menu for April 2023, and ribs were not listed on the menu.

Residents interviewed say they do not have a need for their food to be chopped and that most meals served do not have bones in them.

Continued on 9099-C.

There is insufficient evidence to prove that R1 was served food not meeting their dietary restrictions, therefore the allegation is deemed unsubstantiated at this time. However, a Technical Violation is being given to ensure special diet needs are properly communicated and posted in the kitchen for resident health and safety.

Exit interview conducted, technical violation and report given.