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32 | It was reported that resident #1 missed a scheduled medical appointment due to staff negligence. Information was received that R1 receives an injection for cancer every 3 weeks at a medical facility and this injection keeps the resident from having diarrhea which is caused by the cancer. Reporting party (RP) stated that the appointments are scheduled by family and the facility’s driver takes R1 to these appointments. According to the RP, recently, the staff forgot to take the resident to the medical appointment for the injection. Since R1 did not receive the injection, the resident had diarrhea for many weeks and as a result facility reported that R1’s level of care will increase service fee of $1250.00 a month more. Resident records reviewed revealed that R1 moved into the facility in 2023. R1’s care service level is level 2; needs and services plan dated 12/23/2025 indicates R1’s level of care need for bathing enhanced to twice a week shower/bathing with 2 persons assist; toileting needs was moderate – standby assists. Records reviewed and staff interviews revealed that increase in R1’s level of care services was communicated to R1’s family/responsible person. Staff confirmed that R1’s increase in fees was a result of R1’s enhanced service needs. Attempt was made to interview R1 however R1 was not present at the facility during LPA’s visit on 01/14/2026, 01/30/2026 and 02/18/2026.
Interviews conducted and records reviewed revealed that R1’s medical appointments are managed/scheduled by the family; facility provides transportation only.Staff reported that after the 12/5/2026 medical appointment they were notified by the medical facility where R1 receives the injection for the medical condition every three weeks would require personal assistance during the medical appointment. It was agreed that family would accompany R1 to the next medical appointment. Staff reported that the reason R1 missed the medical appointment in the month of 12/2025 was due to R1’s family not being able to attend. In addition, R1 and family were responsible for managing medical appointments and arrange for transportation. Records reviewed and interviews conducted with staff revealed that R1 was provided transportation by the facility to two medical appointments which were scheduled for 12/05/2025 and another on 12/26/2025. Staff confirmed that these appointments were known and scheduled with the facility in advance and R1 was assisted and provided transportation to and from the medical appointments. No other medical appoint was recorded or scheduled with the facility for R1. Reporting party did not provide any evidence to support that facility was notified of scheduled medical appointment.
Based on the above information gathered, there is insufficient evidence to support the allegations or that a violation occurred; therefore, the allegations “Staff did not take resident to medical appointment” and “Resident accrued an unauthorized charge that was due to staff negligence” are deemed unsubstantiated at this time. Exit interview conducted and copy of report provided.
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