complaint·August 18, 2022

Manager (S1: Kevin Arutyunyan), Staff #2, and Resident #3. LPA/RA did not interview Resident #1 who moved on 09/16/21, Resident #2 moved on 04/24/21, and Resident #4 moved on 10/25/21. LPA/RA Ceniceros reviewed (between 10:00 a.m. - 10:45 a.m.) pertinent documents: Admissions Agreement, Emergency I.D. & Information; Record of Resident's Safeguarded Cash Resources, Billing Statements, and March 2021 Invoices for Residents #1, #2, #3, #4. Regarding Allegation #1 : this investigation revealed that Residents #1, #2, #3, and #4 were a participants of the Pacific PACE Program. Facility would bill Pacific Pace $60 per day for Residents #1, #3, #4 and $33 per day for Resident #2. Pacific PACE would pay a portion of the residents' rent and the residents would pay the remaining balance. (LPA/RA reviewed Resident #1, #2, #3, and #4 Admission Agreement for the rent amount and March 2021 Invoices that documented Resident #1, #2, #3, and #4 "outstanding" balances.) Interviews conducted with facility staff corroborated that Pacific PACE pays for the level of care for Resident #1, #2, #3, and #4; and, the residents pay for their room and board from the money they receive from SSI. In an attempt to change the payee to the facility, Residents #1 #2, #3, and #4 refused to do so. Pacific PACE was being billed each month; however, the facility had been receiving late payments from Pacific PACE and no payments from Residents #1, #2, #3, and #4 which accumulated to an "outstanding" balance. The facility was willing to take a loss from not collecting the "outstanding" balances from Residents #1, #2, #3, and #4 as an agreement that the facility become the payee for Residents #1, #2, #3, and #4. Resident #1's personal funds were going elsewhere (family), but never paid the rent. Resident #2 had own card with funds and spent money on personal items, but nothing towards the rent. Resident #3 had own card with funds and spent majority of money on personal items, but nothing towards the rent. Resident #4 had own own card with funds and spent the money on personal items, but nothing towards the rent. (LPA/RA reviewed Invoice #0324B (dated 03/01/21) documented Resident #1 owed $6,701.42; Invoice #0320B (dated 03/01/21) documented Resident #2 owed $6,523.17; Invoice #0321B (dated 03/01/21) documented Resident #3 owed $5,701.42; Invoice #0329B (dated 03/01/21) documented Resident #4 owed $5,450.35). Based on the evidence gathered and interviews conducted and records reviewed, LPA/RA Ceniceros did not observe financial abuse from the facility to Residents #1, #2, #3, and #4. 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; therefore, the allegation of FINANCIAL ABUSE: Financial Abuse is found to be UNSUBSTANTIATED. Regarding Allegation #2 : this investigation revealed that Residents #1, #2, #3, and #4 are participants of the Pacific PACE Program who pays for the level of care for Residents #1, #2, #3, and #4. Pacific PACE Program began; however, Residents #1, #2, #3, and #4 did not have an assigned social worker; therefore, facility staff would make notifications regarding these residents thru a direct line to Pacific PACE and left a message and followed up with an e-mail regarding the incident. (LPA/RA Ceniceros reviewed e-mails (dated 03/01/21, 03/08/21, and 03/24/21 from (former) Staff #3 (S3: Business Office Manager, Gretel De San Diego) to the agency regarding Residents #1, #2, #3, and #4 "outstanding" balances, effective 03/01/21. (LPA/RA reviewed Invoice #0324B (dated 03/01/21) documented Resident #1 owed $6,701.42; Invoice #0320B (dated 03/01/21) documented Resident #2 owed $6,523.17; Invoice #0321B (dated 03/01/21) documented Resident #3 owed $5,701.42; Invoice #0329B (dated 03/01/21) documented Resident #4 owed $5,450.35). Based on the evidence gathered and interviews conducted and records reviewed, LPA/RA Ceniceros observed documentation of communication (via e-mail) between the facility and agency. 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; therefore, the allegation of REPORTING REQUIREMENTS: Facility staff failed to report incidents to agencies is found to be UNSUBSTANTIATED. An exit interview has been conducted and a copy of the Complaint Report provided to Asst. Administrator, Alexander Solorio.