Every finding on record at Nurses Night & Day, Inc.

A complaint investigation for case# 1008787 entrance conference was conducted on 5/22/2025 at 10:17am. Census: L&C - 11 LHHS - 50 PAS – 32 ABBREVIATIONS: ADM – Administrator ALT ADM – Alternate Administrator ALT DON – Alternate Director of Nursing DON - Supervising Nurse / Director of Nursing HHA – Home Health Aide L&C - Licensed and Certified LHHS – Licensed Home Health Services PAS – Personal Assistance Services TULIP – Texas Unified Licensure Information Portal. SW - Social Worker

Property and person treated with respect CFR(s): 484.50(c)(1) Have his or her property and person treated with respect; This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to respect a patient’s right to have his person and property treated with respect, consideration, and recognition of his individuality and personal needs by removing a firearm and ammunition without the patients consent. This resulted in the patient’s belongings being removed from the property, a police report being filed, and an investigation to be done. The firearm and ammunition was used for the clients safety. This also resulted in the patient’s inability to confide in the agency’s vetting process. Review of pre-survey complaint revealed that the incident was made by the patient regarding a missing firearm and ammo removed by Home Health Aide A During record review on 5/22/25 of the complaint filed in the complaint log by the agency, the investigation revealed a written statement by HHA A stating that she intentionally removed the firearm and supplies without patient #1’s consent or knowledge and placed them into a piano chair. HHA A documented that she did not remove the items from the patients home. During an interview via phone with HHA A, on 5/22/25 at 11:34 am, she stated that she removed the firearm and ammunition out of the bag in which the patient stored them in, without the patient’s consent, and relocated the items into a piano chair which had a compartment. HHA A was asked why she removed the gun from its original location and storage bag, she stated she was afraid of guns and the patient “had a crazy look in his eyes” when he mentioned that he didn’t want her to move the “green bag” from underneath the table. When asked how she knew there was a gun in the “green bag”, HHA A stated that the patient informed her that there was a “pistol” and ammunition along with other items in the bag. When asked when she removed the firearm and ammunition out of the bag, she stated she was asked to “tidy up” the patient’s home, removed the items from the bag when then patient walked into his room, and placed them in the piano chair. HHA A stated that the patient contacted her via phone on 5/9/25 “late night, early morning” but could not specify a time, regarding the missing firearm. She stated that she attempted to inform the patient of where the firearm was located but the patient was already upset and threatening to report her. She stated that he was so upset that he didn’t allow her to speak or give her time to inform him of where the firearm was placed. HHA A called the administrator, immediately after the conversation between her and the client on 5/9/25 and informed her of the incident as well as where the firearm was located. She was then contacted by the social worker of the agency on 5/9/25 and was asked to make a written statement regarding the incident. HHA A made a written statement of the incident. An interview with patient #1 on 5/22/25 at 11:48am was attempted but the patient was unsure of who the surveyor was and refused to continue the conversation further. During an interview with the alternate administrator on 5/22/25 at 12:16pm, she revealed that the administrator was sick and had difficulty breathing. She stated that the social worker was involved with the investigation of the incident and had more information regarding the events. During an interview with the social worker on 5/22/25 at 12:19pm, she revealed that the administrator called her at the 6:51am and asked that she contact the patient upon opening hours regarding his firearm. The SW A agreed to make the phone call upon opening hours, 8am. SW A then received three text messages on 5/9/25 at 7:28am from patient #1, which were forwarded text messaged sent by HHA A. These messages were stating the reasons why the HHA moved the gun without permission, asked for an apology from the patient, and requested that the patient not inform the agency of the matter. Shortly after the patient called SW A to discuss the incident in detail. Patient stated to her that the firearm and ammunition were missing, gave her the details of the incident, and that he filed a police report. She stated that Patient #1 requested HHA A not service him any longer. SW A contacted HHA A on 5/9/25 at 8:56am and informed her that she was not to service the patient any longer pending the investigation. SW A stated HHA A became upset and stated that she was afraid Patient #1 was going to hurt her, so she placed the gun in a piano chair without the clients consent or knowledge. SW A verbalized again that the HHA has been taken off the services for patient #1. SW requested that HHA A make a written statement of the incident and submit it to her. SW was asked to contact the administrator and ask if she was willing to be interviewed by the surveyor. On 5/22/25 at12:53 pm surveyor interviewed the administrator. When surveyor asked the administrator to go through the details of the incident, she was unable to speak much due to complications of a respiratory condition. The surveyor ended the interview with the administrator. Patient #1 returned the surveyor's call and an interview with the patient on 5/22/25 began at 1:03am. Patient #1 stated he had a green bag with his firearm and ammunition that was placed underneath his table in the living room on 5/8/25. The patient walked away from then area of where the bag was located. Upon returning he found the “green bag” was missing from its original location. When patient #1 asked HHA A where the bag was, she initially denied that she moved the bag but then stated she placed the bag in his room then proceeded to return the bag to the patient. Patient #1 stated because of the weight of the bag he had not noticed the difference of his items being missing. On 5/8/25 late evening, Patient #1 noticed the firearm and ammunition were removed from the bag. He also stated he had medication, batteries, and silverware missing. Patient #1 stated that when he found his firearm and ammunition missing that he contacted the HHA at 2 am on 5/9/25 to inform her that he knew it was stolen from him. He did not state that the HHA informed him of where the firearm was mentioned. Surveyor asked if he was informed the firearm was in a piano chair. Patient #1 stated the storge area of the piano chair was broken underneath and therefor doesn’t have a compartment for any type of storage. He also stated there was a post that weighs approximately 800 pounds that would have to be moved before being able to access the piano chair. Patient #1 stated that after the call made to the HHA she then text him and gave him a confession the removed items without his permission or consent. These texts were obtained by the patient. Patient #1 contacted the agency and made a police report on 5/9/25 regarding the missing firearm and ammunition. Patient #1 stated during the police report he was informed that the HHA had been under review by the police department previously, but the officers could not go into detail. Patient #1 stated this left him feeling uneasy for his safety and allowing further aids into his home. Surveyor asked Patient #1 if he had video footage of the incident. Patient #1 stated that he did not. Patient #1 stated he found the firearm on his front porch in a grocery bag on 5/18/25 after “Sunday service”. After he found the grocery bag, he contacted the police department and informed them of the returned items. He was asked if he wanted to proceed with pressing charges. He stated he is proceeding with pressing charges. Patient #1 stated HHA A contacted him to inform him of why she hid the firearm and ammunition from him after she found out that charges were being filed against her. He states that the HHA stated she did not remove the firearm out of his home but did remove the items from the green bag and placed them in a different area of the home. He stated he was still pressing charges regardless of the returned items. Review of the agency’s policy dated April 2020 titled “Rights and Ethics Rights/Responsibilities Policy No. 1- 001.1” read in part: PROCEDURE 1. the patient will be informed verbally and in writing during the initial evaluation visit in advance for furnishing care to the patient, of the following: M. The right to privacy, security, and respect of property and person. N. The right to be free from mental, physical, sexual and/ or verbal abuse, including injuries of unknown source, neglect, misappropriation of property, or exploitation. O. The right to voice a complaint or concern regarding care or services. The availability of other sources to receive questions and complaints and assist in resolution.