complaint·September 3, 2025

Interviews with the Executive Director, Nurse, and Resident Services Coordinator indicated that R1 would be a good fit for the memory care unit at the care home. Hospital Records indicated that they spoke with facility staff on January 24, 2025 indicating that R1 could return to facility after lunch. Hospital was notified by facility on January 24, 2025 that R1 currently resides in assisted living and would be moved to memory care pending discussion with R1’s responsible party. Hospital completed an LIC602A for R1 to go back to the facility in memory care and faxed the form to the facility. R1’s Resident Notes, dated January 24, 2025, indicated that the facility spoke with R1’s responsible party and informed them about memory care placement for R1, and responsible party indicated ok. R1’s Residency Agreement, dated June 26, 2023, indicated that “If we determine that the level of care, we are providing you is not appropriate for your needs, we will implement a change in level of care and consult with you regarding the change. We will also inform your Responsible Person(s) of the need for an implementation of any such change”. Hospital Records indicated that, on January 25, 2025, the facility notified them that they will not be accepting R1 back. R1’s Resident Notes, dated January 25, 2025, indicated that they are not able to take R1 back due to safety issues and concerns. Staff interviews indicated that medical records stated R1 is a high risk of accidental self harm/self neglect if left unsupervised. However, medical records obtained indicated that there was no evidence of any self-harm, suicidal or homicidal ideation, plan or intent. Medical Records indicated that, on January 26, 2025, hospital staff spoke to R1’s responsible party who indicated that they would reach out to the facility to find out why they will not take R1 back as rent was paid until the end of the month. Medical Records indicated that R1’s responsible party assisted the hospital in finding placement for R1. Based on documentation reviewed and interviews conducted, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page. Exit interview conducted. A copy of this report and appeal rights were provided.