Eula Montgomery, NA

Nursing Service

Subject: Investigation

August 16, 2017

The CLC is performing an investigation of the following reports from June 16th, 2017. We need you to
provide your response to each of the items below. Responses can be made within the document below
or you may complete ROCs for each. Responses must be submitted from your VA mail account no later
than 8/23/17.

1. June 16th, there was a report of physical contact between you and another staff member, David
Byers.
The CLC is performing an investigation of the following reports from June 16th, 2017. We need you to
provide your response to each of the items below. Responses can be made within the document below
or you may complete ROCs for each. Responses must be submitted from your VA mail account no later
than 8/23/17.

2. June 16th, there were reports that you were being loud and disrespectful toward 3 other staff
members, while in the presence of residents.

June 16th, reports from multiple residents where there was a failure to provide them proper

care.

a.Provided a shower without the light on

b.Completed shower with cold water
c.Failure to perform peri-care and clean skin folds
d.Failure to verbally interact with residents while providing care by not acknowledging
their questions/statements/concerns.
e. Providing care that was considered rough
3. On June 16th, did not follow directive of charge nurse to report to another unit when instructed.
Gaila M. MacAdams, RN, BSN

CLC Nurse Manager