ADM and S1 stated that the facility had an agreement with HeatRX to provide heat treatment whenever bed bug activity was identified. They stated that monthly spray services for bed bugs were performed regardless of whether activity was reported. The Administrator further stated that bed bugs had been an ongoing issue for approximately five years. ADM also stated that, as of August 2025, the facility had not received any doctor’s After Visit Summary reports for any resident, nor had any residents been prescribed medication for bed bug bites.

R1 stated that there were a lot of bed bugs in R1’s room, clothing, towels, and drawers. R1 stated that R1’s room had been sprayed for bed bugs about three times and heat-treated twice since February 2025. R1 further stated that R1’s bedding had only been washed a total of three times and R1’s room was cleaned three to four times per week.

R2 stated that they occasionally saw bed bugs on their blanket and pillow, but had not received any bites. R2 stated that the facility washed R2’s bedsheets occasionally when deemed dirty and that R2’s room was cleaned daily.

R3 stated that they had experienced bed bugs, but after the facility heat-treated R3’s room, no further bed bugs were present. R3 stated that R3’s bed sheets were washed once a month and R3’s room was cleaned daily.

R4 stated that they experienced bed bug bites, observed bed bugs crawling on them every night, and continued to have bed bug bites. R4 stated that staff were aware of the bed bug issue. R4 further stated that staff washed R4’s bed sheets every other week and cleaned R4’s room daily.

R5 stated that they had seen bed bugs in the past, but the problem resolved after the facility sprayed R5’s room. R5 stated that staff washed R5’s bed sheets weekly and cleaned R5’s room daily.

On 08/20/2025, LPA obtained and reviewed a copy of R1’s doctor’s After Visit Summary report, dated 08/07/2025, which confirmed that R1 had been diagnosed with bed bug bites and had been prescribed medication for treatment.

Continued on LIC9099-C

On 08/20/2025, LPA obtained and reviewed HeatRX’s monthly bed bug treatment service reports from January 2025 through July 2025. Each report documented live bed bug activity, and in response, the beds and bed frames in affected rooms/units were sprayed or rooms were heat-treated.

On 08/20/2025, the LPA reviewed the facility’s file for past Incident Reports and found that no reports had been submitted regarding bed bug issues at the facility.

On 08/20/2025, during the facility visit, LPA observed R1 in their room. R1 displayed visible bed bug bites and showed LPA a photograph of bed bugs on their blanket, dated 07/29/2025. LPA inspected R1’s mattress and observed clustered dark-colored spots.

Based on observations, interviews conducted, and records reviewed, the Administrator acknowledged that the facility has had ongoing bed bug issues for several years. 5 out of 5 residents interviewed reported seeing bed bugs or experiencing bed bug bites. Clustered dark-colored spots on the mattresses were observed in R1’s rooms. In addition, monthly pest control service reports from January 2025 to July 2025 documented live bed bug activities. Despite regular treatment, bed bugs continued to be present in the facility. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

The department had already issued a citation to the facility for the bed bug deficiency prior to the present complaint. Since the same condition was covered under an existing citation and corrective action and plan are in the process, a duplicate citation for the same deficiency will not be issued.

An exit interview was conducted with the Administrator and Lead Caregiver. A copy of this report was discussed and provided to the Lead Caregiver, Elizabeth Espique, whose signature on this form confirms receipt of this report.