Complaint·April 14, 2022

Review of R1’s care plan dated 11/26/2019 revealed R1 was independent of all care needs except for assistance with self administered medications. Investigative interviews revealed that on 10/19/2021, the Executive Director told R1’s responsible party that staff were assisting R1 in the mornings. Review of facility’s levels of care tool document dated 10/19/2021, R1 was assessed by Executive Director Milena Petrosyan to have mild confusion and forgetfulness, and required verbal reminders to shower, engage in grooming and hygiene activities, and had occasional emotional behaviors. Investigative interviews revealed that between 10/19/2021 and 10/30/2021, the Executive Director and other facility staff discussed R1’s need for Level 2 care with R1’s responsible party via telephone and in-person multiple times. On 10/30/2021, R1’s responsible party received a pro-rated invoice for Level 2 Care services provided from 10/19/2021 to 10/31/2021 and an invoice for November 2021 for room and board and Level 2 Care. Investigative interviews and record review revealed R1’s responsible party was not provided with a written notice of the rate increase due to level of care at that time. Review of facility’s levels of care tool document dated 2/25/2022, R1 was assessed by the Executive Director to be diagnosed with dementia, had moderate confusion, disorientation to time, and required verbal cuing. R1 was also assessed to need hands on assistance for bathing and dressing, was unable to follow exit directions, and required staff to escort R1 to activities and dining. On 2/28/2022, R1’s responsible party received an invoice for March 2022 for room and board and Level 3 Care services. Investigative interviews revealed between 1/1/2022 and 3/1/2022, Administrator and CEO spoke with R1’s responsible party multiple times via telephone and in-person to discuss R1’s need for Level 3 care. R1’s responsible party was not provided with a written notice of the rate increase due to level of care at that time. A sampling of resident records were reviewed and revealed that eight of nine residents' (R1-R9) records did not contain a written notice of rate increase. Based on the evidence obtained during the investigation, the Department has found that the facility did not provide a written notice to R1’s responsible party regarding the rate increase due to increase in level of care. Therefore, the allegation is deemed substantiated, which means the preponderance of the evidence standard has been met and the allegation is valid. The following deficiency was cited per CA Health and Safety Code Title 22 and noted on the attached LIC9099-D page. An exit interview was conducted with CEO Barbara Anne Crowley and Executive Director Milena Petrosyan. A copy of this report and the Licensee's Rights (LIC9058 01/16) were provided to CEO and Executive Director via email. An email receipt confirms the acknowledgement of these documents.