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25 | Licensing Program Analyst (LPA) Tuesday Cabiness conducted a (24) hour case management, due to a death of a resident. LPA received an email on 08/19/2024 from the Administrator, that resident # 1 (R1) had committed suicide at the facility. LPA reviewed the email on 08/20/204, and conducted the visit. LPA obtained resident records, interviewed staff and the Administrator. LPA also received the death report pertaining to( R1). According to the report that was received and reviewed by LPA, here is a summary: "On 08/17/2024 at approximate 945pm, the concierge notified the medication room that (R1) had called 911. The med-tech went to the villa while the paramedics was assessing the (R1). (R1) expressed feeling unwell and took Tylenol PM. After evaluation, the paramedics did not transport (R1) to the hospital and (R1) returned to sleep. On 08/18/2024 at approximate 1040pm, (R1) went to the med-room to report not feeling well. Med-tech took (R1's) blood pressure, which was high, and 911 was called to transport (R1) to the hospital. 911 diagnosed (R1) with high blood pressure and during assessment, resident stated that if they did not transport (R1) to the hospital '(R1) would commit suicide'. Resident was sent to CMH (Community Memorial Hospital) for evaluation. On 08/19/2024 at approximate 4am, resident was discharged back to the community. On 08/19/2024, resident had breakfast at 715am, and lunch at 12pm in the main dining room with staff served resident. Resident also attended the 1030am music event in the front lobby. Med tech went to resident’s villa at 130pm to check on resident and obtain hospital discharge paperwork, Staff found resident hanging by a rope around the neck which was tied to (R1's) kitchen divider shelving. 911 was immediately called and upon arrival CPR was performed and resident was pronounced deceased".
According to the Administrator, the police interviewed staff; there was no police report number provided or identification of names by the officers who came to the facility. From all the information obtained during the visit, at this time, there is no further action to be done; unless LPA receives more information from the facility or the police department.
Exit interview and copy of report provided. |