complaint·January 3, 2024

There are no records that would indicate R1 requires a higher level of care then what the facility is able to provide. There are no medical records stating the resident requires a nursing facility or is inappropriately placed. During the course of interviews conducted, both the Resident Care Director and Executive Director indicated that they discussed with R1's responsible parties that in their opinion, R1 would benefit from having access to a larger, more secure outdoor area due to exit seeking behaviors. There was no evidence found to support that the facility staff was prohibiting R1's responsible parties from relocating R1 if they felt a higher level of care was warranted. Based on the records reviewed and the interviews conducted the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened, or is without a reasonable basis. Allegation 2 - Staff are billing resident for services not provided: LPA Jensen reviewed the most recent Service Plan, Service Agreement and Memory Care Assessment. The Service Agreement specifies various services including but not limited to extreme weather monitoring, elopement risk and behaviors. The Service Agreement indicates how many providers are needed during which shifts and the frequency of the service needed. While each individual service is listed as having an estimated monthly cost of zero, there is a section that provides for the level of care and pricing information which is derived by multiplying the point value of an assessment conducted by a given dollar amount. This Service Agreement was signed by the responsible party on 9/1/23. The Service Agreement is directly correlated to the Service Plan which lists services that will be provided and adds specific notes as to what those services entail. The Memory Care Assessment lists various activities of daily living, functional capabilities, cognitive capabilities and psycho/social capabilities with each category being assigned a point value. R1 was charged for additional services based on the needs outlined in the Service Agreement, Service Plan and Memory Care Assessment collectively. LPA Jensen conducted interviews with care staff and reviewed progress notes which confirm that R1 was receiving services related to exit seeking behaviors and declining cognitive function. LPA Jensen compared R1's physician report from the time of admission to current and confirmed that R1 has had a deterioration of condition thus warranting a new service plan arrangement. While the service plan and service agreement may be perceived as convoluted and unnecessarily difficult to understand they appear to be in compliance therefore the allegation is UNFOUNDED. A finding means that the allegation is false, could not have happened, or is without a reasonable basis. An exit interview was conducted and a copy of this report, appeal rights and the LIC 811 was provided. A finding of UNSUBSTANTIATED means that although the allegation may have happened, the preponderance of evidence does not prove it. An exit interview was conducted and a copy of this report, appeal rights and an LIC 811 was provided.