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32 | Allegation #3: It was alleged that staff do not ensure residents are provided prescribed medication.
To investigate the allegation, on 09/04/2025, from 10:30 a.m. to 12:30 p.m., during the initial complaint visit, LPA interviewed staff and six (6) out of six (6) residents. LPA also obtained and reviewed resident and facility documentation. On 03/10/2026, from 10:30 a.m. to 2:00 p.m., LPA conducted a subsequent visit and interviewed twenty-one (21) out of twenty-one (21) residents, and resident #1 (R1). LPA also audited and inspected residents’ medications and medication administration records (MARs), including those for R1.
According to the complaint, it was alleged that R1 missed morning medication. However, records reviewed for R1 revealed that R1 was admitted to the facility on 07/31/2024, and medication management was not initially provided by the facility. Documentation indicated that R1 was authorized by their primary physician to store and self administer their own medication. The facility did not begin providing medication management services for R1 until September 2025.
The alleged missed medication was not specifically identified or documented. Records reviewed after the facility began providing medication management indicate that medications were administered in accordance with physician’s orders. Interviews conducted with residents revealed that they have not missed medications administered by staff. Additionally, several residents reported that they independently store and self administer their own medications without staff assistance. R1 reported to LPA that they have not missed any medication administered by staff.
Based on record review and interviews conducted, there is insufficient evidence to support the allegation that staff failed to ensure residents receive prescribed medication. Therefore, the allegation is determined to be Unsubstantiated at this time.
Allegation #4: It was alleged that staff do not treat residents with dignity and respect.
To investigate the allegation, on 09/04/2025, from 10:30 a.m. to 12:30 p.m., during the initial complaint visit, LPA interviewed six (6) out of six (6) staff. LPA also obtained and reviewed resident and facility documentation. On 03/10/2026, from 10:30 a.m. to 2:00 p.m., LPA conducted a subsequent visit and interviewed twenty-one (21) out of twenty-one (21) residents, and Resident #1 (R1).
(See LIC9099C)
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