Residential Care Services Investigation Summary Report

Provider/Facility: Eagle Springs Senior AlzheimersCommunity (1013009)

Intake ID(s): 3329762

License/Cert. #: AL2400Investigator: Connelly, Krista Region/Unit: RCS Region 1/Unit C Investigation

Date(s):04/07/201704/10/2017

through

Complainant Contact Date(s): 04/03/2017, 04/25/2017Allegations:1. Reporter alleged facility did not issue refund within 30 days of named resident's discharge.

Investigation Methods:Sample: Named resident

(discharged), onedischarged resident andfour current residents.

Observations: General care, residentcondition, hygiene andactivity, staff-residentand resident-residentinteractions, staffing andstaff availability,response to call lights.

Interviews: Staff, Residents andOthers not associatedwith the facility.

Record Reviews: Resident records, facilitypolicies.

Allegation Summary:Residents clean and groomed. The facility met minimum regulatory requirements for staffing and general resident care. Facilityidentified refund had not been submitted to off-site billing office timely and refund not issued within 30 days.

Unalleged Violation(s): Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

Refer to Statement of Deficiency dated 4/25/17.

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