complaint·January 6, 2024

INVESTIGATION REVEALED THE FOLLOWING: Allegation: Staff refused to allow resident’s hospice agency to provide care to resident as ordered by a physician Based on records review, Admission Agreement indicates Resident #1 (R1) was admitted to the facility on 12/29/2022. A hospice referral for R1 from SCAN Health Plan with Healing Care Hospice was dated 12/30/2022. It was alleged that staff refused to allow resident’s hospice agency to provide care to resident as ordered by a physician. On 1/9/2023 from 11:00 am – 1:55 pm, LPA Lourdes Montoya conducted interviews with four out of four staff (S1-S4). LPA attempted to interview five out of five residents (R2-R6). Two out of five residents were sleeping, two out of five residents refused the interview, and one out of five residents was unable to maintain a conversation. R1 was transferred to another facility and LPA was unable to obtain statements from R1 during the visit. Interviews with six witnesses (W1-W6) disclosed that Healing Care Hospice agency was the selected and preferred hospice agency to provide hospice care services to R1. Two out of six witnesses revealed the visiting nurse from Healing Care Hospice agency attempted to visit and assess R1 on 12/30/2022 around 6:00 pm, but facility staff denied the nurse an entry to the facility. W5 revealed R1 was transferred to another facility on 1/5/2023 due to the facility’s refusal to use R1’s preferred and contracted hospice agency. Based on interviews conducted, two out of four staff (S3-S4) claimed they were confused about who is supposed to provide hospice care to R1. Both staff stated Global Hospice delivered a hospital bed, comfort kit, oxygen tank, and bedside table to the facility for R1 but another hospice agency (Healing Care Hospice agency) attempted to assess R1 on 12/30/2022 and the hospice nurse was denied entry. Two out of four staff (S1-S2) claimed there was no doctor’s referral for Healing Hospice Care agency to provide hospice care to R1. They also claimed Healing Care Hospice Nurse was not denied entry on 12/30/22 instead the visit was only placed on hold due to a confusion which hospice agency, between Global Hospice and Healing Care Hospice, was selected by R1’s family. Report continued in LIC 9099C Based on LPA’s observation on 1/9/2023, a hospice comfort kit stored in the medication cabinet with R1’s name of the label was provided by Global Hospice Agency but there was no doctor’s referral for Global Hospice Agency. LPA also observed a hospital bed in the front patio. Per interview with a staff (S3), the hospital bed in the front patio was provided by Global Hospice for R1’s use. Based on information gathered, there is sufficient evidence to prove that staff refused to allow resident’s hospice agency to provide care to resident as ordered by a physician. Based on the department’s observations, records review and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 is cited on the attached LIC 9099D. Exit interview was conducted and Appeal Rights was discussed with Jeremy Nabres/ Caregiver. A hard copy of the report and Appeal Rights were provided. INVESTIGATION REVEALED THE FOLLOWING: Allegation: Facility staff refused to refund resident's unused rent payment Based on records review, Admission Agreement indicates Resident #1 (R1) was admitted to the facility on 12/29/2022. R1 moved out and transferred to another facility on 12/5/2023. It was alleged that facility staff refused to refund resident's unused rent payment. On 1/9/2023 from 11:00 am – 1:55 pm, LPA Lourdes Montoya conducted interviews with four out of four staff (S1-S4). LPA attempted to interview five out of five residents (R2-R6). Two out of five residents were sleeping, two out of five residents refused the interview, and one out of five residents was unable to maintain a conversation. R1 was transferred to another facility and LPA was unable to obtain statements from R1 during the visit. The department reviewed Resident’s (R1) service records. Based on records review, the Admission Agreement indicates “Resident is required to pay a full amount of Non-refundable Board and Care fee upon admission”, and “A thirty days written notice of intent to vacate is required or will be charged a full month pay on the following month or until all belongings are removed from the facility”. Based on interviews conducted, S1 stated the facility is willing to refund a prorated amount based on the days R1 resided in the facility. Based on LPA’s follow-up telephone interview with S1 on 1/10/22, S1 stated a refund letter for R1 was generated and a copy will be provided to the department. LPA received and reviewed the refund letter which indicates the facility has refunded R1 a prorated amount of $4600.00 of which $1400.00 was charged for her seven days of stay at the facility. Based on the information gathered, there is insufficient evidence to corroborate the above allegation. Based on the department’s observations, interviews and records review, the preponderance of evidence standard has not been met therefore the above allegation, “ Facility staff refused to refund resident's unused rent payment” is found to be UNSUBSTANTIATED . Exit interview conducted. A copy of this report was provided to Jeremy Nabres/Caregiver