complaint·October 23, 2023

Investigation Revealed the Following: Allegation: Facility overcharged a resident in care. The details of the complaint alleged that the facility overcharged a resident while in care. During the records review, LPA Iniguez reviewed the following: LPA assessed the email from the facility that was sent to (RP) stating where the billing error was; the email stated the following: "Good Afternoon, (RP), I hope you are doing well. I apologize for the delay. After reviewing (R#1) 's account, we have found that in January and February of 2022, there was an SSI increase of $132.40 each. However, after further reviewing it with the administrator, we have decided to clear the balance owed. The balance might still show in next month's statement, but you can disregard it. If you have any questions, please let me know. Best Regards, (S#2)-Business Office Assistant-Huntington Retirement-(310) 370-5828". In addition, during the facility records review, LPA examined FAS. LPA found that during this current year of 2023, no similar allegations were found. During the Interview with the Reporting Party (RP), she stated that on 10/20/23, the Licensing Program Analyst spoke with (RP) over the phone; LPA asked (RP) what concerns she had right now about the overcharge of the facility to the resident. (RP) stated that the facility did not explain to her what these overcharges come from. (RP) stated that (R#1) is under the PACE program at WELBE. Finances are distributed between private income, Social Security income, Medical and Medicare. LPA mentioned to (RP) that he will investigate this allegation next week. On 10/20/2023 at approximately 6:30 PM, (RP) texted LPA on his work cell phone. She stated that she had just received an email from the facility regarding (R#1). it was a billing error, and they will waive the charges. In addition, LPA asked (RP) to forward him the email she received from the facility to him for investigation purposes. On 10/21/2023, (RP) emailed LPA stating: "Hello Alfonso, Let's keep the case open until Huntington removes this invoice. At this time, I do not think you need to go out there. I am forwarding you the email for confirmation. Thank you again and have a good day. (RP)". Evaluation Report continues LIC 9099-C During an Interview with the Administrator (A#1), she stated that the people in charge of the billing at the facility are the Business Office Manager (S#1), the Business Office Assistant (S#2), and me. Also, (A#1) stated that the facility has never overcharged a resident while in care. In addition, (A#1) noted the following: (R#1) is in the Medical and SSI program, and at the beginning of every year, most residents get an increase in income from SSI. When the residents receive an increase from SSI, we increased the board rate, and that was the charges regarding (R#1). The two-month increase was from January and February of 2022 and is only the increase amount. We have cleared the amount of (R#1)’ s balance. During interviews with Residents (R#1-R#10), 10 out of 10 stated that they do not handle their finances directly; a family member or legal representative does it. Also, 10 out of 10 stated that the facility has never overcharged them. During interviews with staff (S#1-S#10), 9 out of 10 stated that the person(s) who handles the billing for the residents at the facility is (S#1), (S#2), and (A#1). Also, 9 out of 10 stated they had never known or heard about the facility overcharging residents. During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of the Complaint Report was given to Nina Rejuso/LVN.