complaint·February 2, 2024

INVESTIGATION REVEALED FOLLOWING: Allegation: Facility staff did not provide resident's representative with a statement itemizing all separate charges incurred. The details of the complaint reported the facility failed to provide resident #1 (R1) representative with itemized charges. The complainant reported (R1) was provided with a rate increase of $2,000.00 for an increase of care and did not provide the itemized charges. The complainant claimed that (R1) was contracted for $6094.00 for basic services based on (R1's) needs and services were agreed upon under the contract. The complainant claimed there was no agreement for the additional rate increase of $2,000.00. A request for additional information and supporting documents, the complainant was unable to provide. Resident #1 (R1's) residency began effective 05/30/23. A Residency Agreement between Brookdale Santa Monica Gardens and the legal representative for (R1) (dated on 05/26/23) was signed on 05/28/23. Included in the Residency Agreement are the terms and conditions of the agreement. It specified the Services and Accommodations. The Basic Services included: Accommodation, Dining Service, Utility Services, Housekeeping Service, Laundry and Linen Service, Activities Program, Transportation, Staffing 24-hr daily, Observation and Consultation, and Assistance with Access to Outside Services. The Personal Services (outlined in Exhibit Z of the Residency Agreement contract). In Exhibit Z these services are additional charges not included within the Basic Services and it is based on (R1's) medical assessment and needs and service plan defined as follows: Medications (assistance with medications), Chronic Condition Management (specific care and/monitoring by nurse or care associate for more complex insulin), Nutrition (assistance with planning, preparing or/monitoring nutritional needs), and Service Coordinator. Medication (assistance with scheduling medical/dental or lab appointments). The Residency Agreement included the itemized charges listed on Exhibit A with the following: Community Fee before Move-In of $5000.00, Basic Service Rate of $6505.00, and Personal Service Rate of $1211.00 (itemized in Exhibit Z). In the Addendum to the Residency Agreement Personal Service Rate Maximum Pricing, is outlined under the Personal Service Plan Service Rate Maximum of $7965.00. Under an Addendum to the Residency Agreement Permanent Basic Service Rate Discount, "The Community agrees to discount the Basic Service Rate of $6505.00 by $1626.00 (discount)". According to the Residency Agreement agreed between (R1's) legal representative and Brookdale Santa Monica Gardens (dated: 05/26/23), it indicated itemized charges of the Basic Service Rate $6505.00, Basic Services Discount $1626.00, and Personal Service Rate (Evaluation Report continues LIC 9099-C) (medication management $1101.00, chronic condition management $1982.00, nutrition $330, and service coordinator $110.00) for a total of $8402.00. A signature of acknowledgement from (R1's) legal representative (dated: 05/28/24) validated this is a legal contract, and a legal copy was provided to (R1's) legal representative. On 01/17/24 between 10:00 am - 01:41 pm, the Department interviewed (2) out (2) staff #1-#2 (S1-S2) and stated were both unaware if a request for a statement itemizing all separate charges incurred was ever requested for (R1). (S1-S2), however, provided the Department documentation records for (R1) with the following Residency Agreement (dated: 05/26/23), Assessment Summary (dated: 05/23/23 - 06/20/23, Account History Report (dated: 08/06/23 and 01/17/24), Account Balance Activity (dated: 06/16/23-07/14/23-09/14/23-11-16-23, and 11/30/23) and an internal written communication reference to (R1) were issued. On 02/02/24 between 11:54 am - 12:12 pm, the Department interviewed staff #3 (S3). (S3) identified in the complaint as the business manager is not the business manager, and (S3's) role is the Clinical Specialist/License Vocational Nurse and had nothing to do with residents' charges. (S3's) role was to assist with residents' care with more complex programs. (S3) claimed there were numerous conversations related to (R1's) personal service but does not recall a request for a statement itemizing all separate charges incurred for (R1). (S3) disclosed the medical assessment was performed before (R1) moved in, and it remained the same throughout (R1's) residency at the facility. (S3) communicated that in no circumstances would additional fees for services would be charged without an agreement with the resident or the resident's legal representative. The Department obtained an internal progress note (dated: 08/10/23) of a discussion on a conference call on 08/09/23 with (R1's) legal representative, (S3), and with former Executive Director. The discussion related to (R1's) Care Plan and Medication Management and the Chronic Condition charges was disputed. There was no mention of a statement request for itemized charges. Based on the information provider, an inspection of the facility, observation, interviews, and analysis of records, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated. An exit interview was conducted with Milca Osorio, and a copy of the report was provided.