complaint·October 24, 2024

On 04/03/2024, LPA Chochian conducted a complaint investigation visit to the facility above from 10:00am to 11:00am. During this visit, LPA requested and received relevant documentation pertinent to the complaint allegation for record review. LPA Brian Phillips reviewed the documentation. R1’s physician report states that R1 has a primary diagnosis of Alzheimer’s dementia including the loss of cognitive functions. The documented secondary diagnosis for R1 is atypical depressive disorder with negative mood changes due to changing environments. Medical admission assessments by the facility documented that R1 was forgetful/confused with mood/personality changes. The facility admission agreement was signed and dated by the responsible party of R1 on 07/29/2022 prior to R1’s move in date of 07/31/2022. This admission agreement states that the facility can terminate the agreement upon thirty (30) days written and verbal notice to the resident/responsible party if it is determined that the resident has a need not previously identified and a reappraisal has been conducted with the determination that the facility is no longer appropriate. The admission agreement states that the facility is not designed or licensed to provide higher levels of care for serious mental or emotional disorders. If it is determined a resident is a danger to themselves or others and it is inappropriate for a resident remain in their apartment, then they will be asked to leave the facility and the admission agreement will terminate. The facility may discharge a resident if they present an immediate physical threat or danger to themselves or others. A resident may also be discharged if their dementia/mental disorder results in ongoing behavior that requires care and supervision greater than the facility can provide. Interview and documentation provided by Executive Director revealed that on 01/25/2024 the facility held a meeting with R1’s family to discuss R1’s changes in behaviors and possible evaluation for R1’s changing medical condition. R1’s doctor then ordered R1 to be admitted to a psychiatric hospital for further evaluation. On 01/28/2024, R1’s family, who had been in communication with R1’s doctors, indicated a bed was open in the hospital unit and R1’s family took R1 to the psychiatric hospital for a 14-day time period. All licensing agency interviews with facility staff and the responsible party of R1 indicated that the resident would not be returning to the facility after R1 was evaluated/reappraised while in the psychiatric hospital. Although Reporting Party indicated it was the facility that did not allow the resident to return, the Executive Director provided documentation and notes indicating the hospital social worker suggested to R1’s family discharging R1 to a Skilled Nursing Facility (SNF) for further medication adjustments with a doctor onsite. On February 10, 2024, R1’s family member verbally told the facility R1 would likely not be returning to the facility. R1’s family member then began removing R1’s personal belongings from the facility on 02/20/2024. R1’s family member reported to the facility on 02/23/2024 that R1 was discharged to a SNF. On 02/29/2024, R1’s family Report Continued on LIC 9099-C member confirmed R1’s room at the facility was fully vacated, thus terminating the residency contract. Although R1 did not return to the facility following a stay at the psychiatric hospital, it is unclear whether the facility refused the resident to return or if the family and/or hospital social worker made the decision for R1 not to return. R1 was discharged to a SNF, which is a level of care the facility cannot provide per Title 22 regulations. Based on the information gathered, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore the allegation “facility illegally evicted a resident in care” is deemed UNSUBSTANTIATED at this time. On the allegation: Facility did not issue a refund to a resident in care. It is alleged that R1 had their personal belongings removed from the facility on 02/25/2024 after being in a psychiatric hospital beginning on 01/28/2024. The allegation requests a refund for the days R1 was out of the facility from 01/28/2024 to 02/25/2024, with the resident not returning to the facility. LPA requested and received a copy of the documented facility residence and services agreement/admission agreement. The facility admission agreement was signed and dated by the responsible party of R1 on 07/29/2022. The facility admission agreement has a refund policy regarding the vacating of an apartment, and the refund of unused portion of monthly fee. The monthly fee is defined in the admission agreement as total combination fee of apartment fees and service plan fees. Supplemental support services/additional services are offered for an additional fee. According to the facility admission agreement signed/dated by the responsible party of R1, the facility fees did not include any additional/supplemental support services for R1 while in care. The monthly fee charged to R1 was the combined apartment fee and the service plan fee. If the admission agreement is terminated, the resident must vacate the apartment and remove all property from it. The resident or their responsible party will remain liable for the monthly fee until the effective termination date and all the resident’s property is removed from their apartment, whichever occurs later. The facility may also charge a resident a property storage fee if they fail to remove their personal belongings by the effective termination date. Following the termination of the admission agreement, the facility will pay the resident or their responsible party a refund equal to any amount owed, minus certain conditions including any expenses incurred to store resident’s property that was not removed upon vacating the apartment. According to the facility admission agreement, R1 is liable for the monthly facility fee until all R1’s property is removed from Report Continued on LIC 9099-C their apartment, as that occurred later than the effective termination date. All licensing agency interviews with facility staff and the responsible party of R1 indicated that the resident would not be returning to the facility following R1's stay in a psychiatric hospital beginning on 01/28/2024, but R1’s property was not removed from the facility until 02/25/2024 by their responsible party, who then notified the facility on 02/29/2024 that all R1’s personal belongings were out of their apartment. Therefore, R1’s responsible party is liable for R1’s monthly fee until 02/29/2024 and the facility is not required to issue a refund for the days R1 was out of the facility from 01/28/2024 to the date R1's belongings were removed. However, LPA Dulek was informed during the subsequent complaint visit that the facility chose to issue a refund to R1's responsible party, which was issued sometime toward the end April or beginning of May 2024. Based on the information gathered, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore the allegation “ facility did not issue a refund to a resident in care ” is deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted. Copy of today's report was provided.