complaint·May 6, 2024

LPA reviewed the facility’s brochure which indicates the additional charge for incontinence supplies is currently $450 per month. Staff interviewed reported that there have been issues with incontinence supplies for R1. Per AD, R1 was getting incontinence supplies from a vendor, but there was an issue with R1’s insurance and between October 2023 and February 2024 the facility did not receive incontinence supplies for R1. Because R1 still needed incontinence care, facility staff began using the facility’s incontinence supplies, but AD was not made aware of this change by staff for about two months. R1’s family was charged the additional monthly charge for this five-month period and R1 is back to receiving incontinence supplies from a new vendor. LPA interviewed R1’s family who stated they had had not been made aware that the vendor had stopped delivering R1’s incontinence supplies and that the facility had begun using its own supplies until February 20, 2024 when the facility sent them the invoice for February 2024 via email. Information obtained was conflicting regarding whether the original vendor was coordinated by R1’s family or the facility, the number of months for which the additional charge for incontinence supplies was demanded, and whether the facility attempted to charge late fees for back-owed fees. AD and the licensee corroborated that the facility first notified R1’s family on February 20, 2024 that R1 had begun using the facility’s incontinence supplies and they would be charged an additional fee. LPA reviewed R1’s Appraisal dated July 1, 2020 and R1’s Individual Service Plan dated May 11, 2020 which indicate R1 needs assistance with toileting and incontinence care and interviews revealed that since entering the facility R1 received incontinence supplies from a vendor. However, in October 2023 the situation changed and R1 began needing to use the facility’s incontinence supplies. The facility did not properly notify R1’s family of this change in care and services provided by the facility or that R1’s family would have to pay an additional charge because no notice was provided until February 20, 2024. Regarding late fees, LPA reviewed R1’s Admission Agreement dated July 2, 2020 which states Invoices are … due by the 10th of each month” and “Late fees will occur after the 10th,” but does not specify how the late fee is calculated. However, LPA reviewed the facility’s Plan of Operation, which includes the facility’s approved admission agreement which does not include the language regarding late fees, meaning the facility cannot charge a late fee During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the above allegation is Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative. Regarding the allegation that the administrator is not on the premises a sufficient number of hours to adequately manage the facility: it was alleged that AD is not at the facility and will not be at the facility until the third week of April 2024. LPA interviewed staff who corroborated that AD has been on leave from work due to medical issues since last week and the leave is expected to continue for a few more weeks, but stated that AD is reachable by phone. LPA interviewed AD via telephone who stated that they are currently on medical leave, but they still go to the facility twice a week, they manage the facility from home while recovering and are available by phone, the licensee is also available to be present at the facility, and the medication technicians are in charge while AD is not present at the facility. LPA confirmed during the inspection that, while AD was not physically present, AD is reachable by phone and knowledgeable about the situation at the facility. LPA observed the facility to be clean and organized and observed no health and safety issues, the residents were in good health and good spirits, the staff were responsive to the residents, and the medication technicians were knowledgeable and responsive to residents, pharmacies, and visiting medical professionals to coordinate resident care. Apart from the fact that AD is on medical leave, witness interviews did not reveal information that the facility is not being properly managed or that residents are not receiving proper care and supervision. While AD is temporarily unable to be present at the facility as often as usual, the facility is adequately managed by AD remotely and in-person and by the medication technicians while AD is not present. Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.