complaint·June 14, 2021

Administrator stated to owe R1's responsible party $2907.50 in total, and subtracting $387.50 which had been reimbursed on early March, Facility still owed responsible party $2520.00. On 10/19/20 LPA Flores interview R1's responsible party who stated administrator had said to owe R1's responsible party $2907.50 and two checks have been issued 1) on 3/9/20 for the amount of 2168.72 and 2) on the second week of April for the amount of 387.50 During R1's file review, LPA observed the following; R1 was admitted to the facility on 9/1/18, R1 was taken to the hospital on 1/27/20, from hospital R1 went to nursing home on 2/4/20 facility provided a 30 day notice at the end of January per R1's representative. R1's last physical day at the facility was 1/27/20 and last day of board and room was on 2/27/20. LPA reviewed a facility's letterhead letter dated 3/24/20 with breakdown charges for January and February 2020 as follow; January 2020 Charges for room and board and other services total $5080; Payments $5080 balance $0. February 2020 Charges for room and board (26 days) no charges for other services total $2172.50 Payments $5080 Balance $2907.50. Letter states Facility owes R1's responsible party $2907.50 deducts $387.50 paid on 3/20/21 leaving a balance of $2520.00 owed to R1's responsible party. LPA was provided with a copy of second check issued to R1's responsible party on 4/1/21 for the amount of $2168.27 leaving a balance owe to R1's responsible party of $351.73. Interview with facility's administrator revealed facility has issued two checks to R1's responsible party 1) dated on 3/9/20 for the amount of $387.50 posted bank on 4/9/20 and 2) dated 4/1/20 for the amount of $2168.27 posted bank on 4/9/20. Therefore facility owes R1's responsible party the amount of $351.73. Based on file review and interviews, conducted the preponderance of evidence standard has been met, therefore the above allegation(s) are SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 8 are being cited in the attached LIC 9099D. Exit interview was conducted with Denise Sutton and a copy of report, LIC 9099D, and appeal rights was provided.