complaint·December 17, 2021

Allegation: "Staff did not inform authorized representative of resident's fall resulting in an injury." Based on record review and interviews conducted the findings indicate that on October 10, 2021 former resident (R1) sustained a fall inside the resident's room resulting in bruising and scrapes to the left knee. Picture evidence was obtained. According to staff, R1 had a total of two (2) falls dated [10/10/21 & 10/27/21]. The fall dated 10/10/21 was not reported to Community Care Licensing (CCL). In addition, the authorized representative did not notification via phone call because the phone number listed on R1's face sheet was incorrect, and staff were not able to decipher the exact numbers listed on the emergency contact information document. Resident (R1's) authorized representative became aware of the 10/10/21 fall during a visit shortly after the incident. The authorized representative and med-tech staff (S5) discovered the phone number listed was incorrect. Therefore, confirmed the authorized representative did not receive phone call notification of the fall injury. The second fall dated 10/27/21 was reported to CCL and authorized representative. Caregiver staff notified med-tech staff (S3) who called 911 Emergency. Resident (R1) was transported to Whittier Presbyterian Hospital for evaluation. The resident returned back to the facility the same day. Allegation: "Staff would not itemize the resident's bill." Based on record review and interviews conducted the findings indicate that on September 23, 2021 former resident (R1) docu-signed the "Residency Agreement" that includes a price schedule for services and outlines charges. A "Community Fee of $2,500" and "Basic Service Rate of $1,760" was noted. No additional charges/fees were observed under the "Personal Service Rate" line item; which would include additional care services like bathing and/or incontinence care assistance. It is alleged that resident (R1's) authorized representative received an invoice bill statement with charges that were not agreed upon or authorized. Resident (R1's) family called the facilities several times requesting an explanation of additional charges and a copy of an itemized bill, but did not receive calls back. The itemized bill was provided over 1 week later until the authorized representative went in person to the facility. However, an explanation of the charges was not provided at the time of the visit. The itemized bill listed additional "Personal Service Rate" charges in the amounts of [Showering $128.00 and Bathroom Assist $769.00] totaling an additional $897.00 per month in fees in addition to rent fees. See LIC 9099 for report continuation. According to staff interviews, resident (R1's) family agreed to the shared room rate and a "Personal Service Rate" fee of $128 dollars for shower/bathing assistance. However, the Residency Agreement obtained did not list additional "Personal Service Rate" fees. The Executive Director, Health and Wellness Director, Sales Manager, Business Office Manager were interviewed and all acknowledged that the Residency Agreement does not list any additional charges aside from rent fees. Former resident (R1) no longer resides at the facility and was not interviewed; only R1's authorized representative was interviewed. Supportive document evidence was obtained. Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SU BST ANTIATED . Deficiencies are being cited according to California Code of Regulations, Title 22, Division 6, Health and Safety Code Chapter 3.2 Residential Care Facilities for the Elderly, Article 02.5 Resident's Bill of Rights & Title 22, Division 6 Chapter 8 Article 04. Operating Requirements. An exit interview was conducted with Executive Director Barbara Tyler. A copy of the report an appeal rights were provided.