complaint·January 20, 2023

[Continued from LIC9099, Page 2 of 2] On December 2, 2022, Administrator stated that two blank copies of the Admissions Agreement were given to Resident 1’s (R1 - See LIC811 Confidential Names List) Power of Attorney (POA) for POA to review the agreement at home. The next day, POA returned a signed copy of the Admissions Agreement to the facility. Administrator admitted she did not provide a signed copy because she had given a blank copy to POA previously. In the Admissions Agreement was an addendum signed by POA and Administrator stating that a refund would not be due if a resident on hospice died within the first thirty (30) days of moving into the facility. Facility records showed R1’s care for December 2022 was paid for on December 2, 2022. The signed Admissions Agreement stated that an preadmission fee was not being charged. On December 6, 2022, R1 passed away while on hospice. Outside sources, Licensee, and Administrator confirmed R1’s personal belongings were taken out of R1’s room on the same day, December 6, 2022, leaving only a medical bed and oxygen machine in the room. Outside sources indicated the bed and oxygen machine were considered durable medical equipment (DME) and belonged to an agency contracted by R1’s hospice agency. Outside sources confirmed that the DME was rented to hospice and not the resident. Outside source, Licensee, and Administrator confirmed the bed and oxygen machine were taken out on December 12, 2022. Licensee maintained the DME was considered personal belongings. Licensee chose to refund POA after resident’s death, despite the addendum signed by POA. The date the DME was removed from the facility factored into the refund amount and the date refund was issued. Facility’s refund invoice showed that an admissions fee and a rush fee were charged. Licensee maintained that the fees were verbally agreed to by POA and no written documentation of the fees were created. Outside source records revealed a refund check was issued to R1’s authorized representative on December 21, 2022. Based on the evidence obtained during the complaint investigation, the allegations that the facility did not refund money owed after resident's death and that the Licensee did not provide a signed copy of the Admissions Agreement to authorized representative is found to be SUBSTANTIATED, as there is a preponderance of evidence to show the violation occurred. Pursuant to the California Code of Regulations, Title 22, Division 6, deficiency is being cited on the attached LIC9099D and a plan of correction was jointly developed with Administrator. An exit interview was conducted; a copy of this report and Licensee's Rights (LIC9058) were provided.