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Residential Care Services Investigation Summary Report

Provider/Facility: Welcome Home on 94th (711710) Intake ID(s): 3143495

License/Cert. #: AF752291Investigator: Maulana, Woodetta Region/Unit: RCS Region 3/Unit A Investigation

Date(s):10/02/201510/02/2015

through

Complainant Contact Date(s):Allegations:Named resident who had a history of falls, fell, and complained of and was sent to the hospital for further evaluation andtreatment.

Investigation Methods:Sample: 5 residents to include

named residentObservations: staff to resident

interactionresidents

Interviews: staff Record Reviews: resident records

Allegation Summary:Based on interview and record review, the home failed to immediately notify the residents healthcare provider and family whenthe resident had multiple falls with injury.

The home failed to immediately notify the physician and seek medical advice to reduce the risk of falls.

The home failed to complete the residents negotiated care plan within 30 days of admission to the home.

Unalleged Violation(s): Yes No

Conclusion: Failed Provider Practice Identified Failed Provider Practice Not Identified

see above

No Citation WrittenCitation(s) WrittenAction:388-76-10225-2-a-c-d388-76-10360388-76-10400-2

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Residential Care Services Investigation Summary Report

Recommend Close InvestigationRecommend FindingRCPP Action:

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