It was alleged that staff did not seek timely medical care for resident. It was reported that Resident #1 (R1) is on blood thinners, and staff was unable to stop the bleeding on R1’s skin tear and although staff called 911 at 7:30 a.m., the incident occurred around 10:00 p.m. the previous night, and R1’s leg was bandaged by staff just prior to Emergency Medical Services (EMS) arriving at the facility. Interviews conducted with staff revealed that if a resident experiences a skin tear, it is immediately reported to the medication technician, who cleans and dresses the wound and try and figure out how the injury occurred. Additionally, if paramedics are needed, the medication technician is responsible for making the call. Staff interviews further revealed that R1's family was notified of the skin tear once staff became aware of it through R1's private companion. Staff stated that R1's family member requested that the facility staff address the skin tear and provide appropriate care. The following morning, staff noticed that the skin tear was still bleeding, prompting them to call R1's family again to provide an update. After several attempted calls, R1's family responded and agreed to have paramedics called to transport R1 to the hospital. Interviews with residents indicated that staff frequently communicate with family members when necessary, and residents confirmed that medical assistance has been sought when required. Additionally, residents did not report any concerns with the care provided by facility staff. Furthermore, staff promptly cleaned and dressed the skin tear as soon as they were made aware of it by R1's private companion, prior to the arrival of EMS at the facility. Based on the information obtained and reviewed, there is insufficient evidence to support the allegation of “staff did not seek timely medical care for resident”. Therefore, this allegation is deemed Unsubstantiated at this time.

It was also alleged that staff handled resident roughly causing a skin tear. It was reported that while R1 was being assisted from their wheelchair to bed by two (2) staff members, when staff picked up R1, they threw R1 into bed like a “sack of potatoes” resulting in R1 sustaining a skin tear to the lower left leg. Interviews conducted with staff revealed that R1 was agitated and anxious for their personal companion to arrive. Due to R1's behavior, three staff members assisted in helping R1 to bed, with each staff member reporting that R1 was placed in bed for the night as they typically would on any other evening. Staff denied handling R1, or any other resident, roughly while assisting them at any time during their work at the facility.

Report Continued on LIC 9099C...

Further interviews with residents indicated that staff have always been kind and prompt when assisting them, and residents did not report any concerns regarding the care provided. Additionally, residents denied that facility staff were aggressive or handled them roughly, leading to bruises or cuts. Furthermore, according to a police report dated 04/11/2024, law enforcement conducted interviews and observations but was unable to establish that a crime had been committed against R1 by facility staff. Based on the information obtained throughout the investigation, there is insufficient evidence to support the allegation of “staff handled resident roughly causing a skin tear”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and a copy was issued.