Complaint·May 8, 2025

Interview with (1) administrative staff revealed March of 2022 the facility was using a new fee structure where points were being allocated based on resident’s needs. R1’s Resident Ledger report revealed R1 was billed and rated at 13,692 care points March of 2022. Records review revealed R1 did not have a care points assessment for services rendered. Therefore, the allegation that R1 was being overcharged for services is unsubstantiated at this time. It was alleged “Resident is being charged for services not provided.” It was alleged R1 was being charged for services such as bathing, grooming, and transferring and were not being provided to R1. It was alleged R1’s hospice agency was providing bathes and facility staff would not transfer R1 out of bed. It was also alleged that R1 was being charged $35.00 for Cable television when R1 did not have a television. Interview with R1 was unable to be conducted as they have passed away. Interview with R1’s legal representative was attempted but unable to be conducted. R1’s Resident Ledger report and move in billing ledger revealed R1 was being charged for Cable television since admission in 2017. R1’s care plan dated 03/03/2022 revealed R1 required a (2) person assist for transfers, required assistance with dressing and grooming, and bathing services were being provided by an outside hospice provider. LPA conducted interviews with (4) staff who provided care to R1. (2) of (4) staff interviewed did not recall services provided to R1. (1) of (4) staff revealed R1 was transferred out of bed, while (1) of (4) staff revealed R1 was contracted and staff was unable to move R1 out of bed and would have been reflected in their care points assessment. No documentation for R1's care points assessment was found in R1's file. (2) of (4) staff revealed R1 was assisted with grooming, hygiene, and bathing as needed with R1's hospice agency providing most of the bathing. (4) of (4) Staff did not recall if R1 had a television in their room or was billed for cable television. Therefore, based on interviews and records review the allegation that R1 was being charged for services not rendered is unsubstantiated at this time. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided. On 03/22/2022 Department staff interviewed (1) administrative staff which revealed R1 and their representative did not sign the new revised admission agreement. Records review revealed the admission agreement for the facility had changed March of 2021 and the last admission agreement for R1 was signed in 2017. Therefore, the allegation that the R1 and their legal representative did not receive a copy of the new admission agreement is substantiated. This deficiency was cited for R1 on case management visit on 03/22/2022. Therefore, the facility was not recited on this report. It was alleged “Resident's charges were increased without proper notice.” It was alleged the facility changed their fee structure for services rendered from $6,085.00 to $11,141.97 for R1 March of 2022. It was alleged R1 and their legal representative were not informed of the fee changes. Interview with R1 was unable to be conducted as they have passed away. Interview with R1’s legal representative was attempted but unable to be conducted. Interview with (1) administrative staff revealed all residents including R1 were informed of the fee structure changes in a letter. Letter dated 03/01/2021 revealed residents were informed that the new fee structure would go into effect on the same day and could be referenced in the new residency agreement. Based on the substantiated allegation above, R1 did not sign a revised admission agreement with the new fee structure. Additionally, Health and Safety Code section 1569.655 states residents shall receive written notice no less than 60 days’ prior to increase of fees and must include the reason for the increase and the amount of the increase. No documentation of proper written notice was found in R1’s file. Therefore, based on interview and record review the preponderance of evidence standard has been met and .the allegation is substantiated. California Code of Regulations Title 22, is being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report was provided.