Complaint·December 21, 2021

It was also alleged facility staff did not give R1 medication as prescribed. Record reviews revealed R1’s personal doctor prescribed medication and facility staff did not administer the medication for approximately two months after the date prescribed. An interview with facility staff and an outside source corroborated the delay in administering the medication to R1. Based on the LPA’s investigation, the above allegations are determined to be substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met. Deficiencies are cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations and are listed on LIC 9099-D. LPA Correia conducted an exit interview with Activities Director Emily De La Barre and Licensee Channa Kelly, to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058 01/16) were provided via E-mail. An electronic email read receipt confirms the documents were received. A facility record review revealed the facility must ensure authorization from CHG to verify that the individual is eligible, and the required services to be provided are rendered as appropriate. On September 30, 2020, during facility admission, R1's Primary Care Physician (PCP), a participating member of CHG, conducted a medical assessment revealing R1 required assistance with daily living skills (ADLs), as documented on the Physician’s Report (LIC 602), that deemed R1 eligible for CHG assistance. An outside source interview revealed on January 28, 2021, that the PCP conducted a re-assessment and determined R1 no longer met the criteria for CHG assistance. The PCP stated R1's conditions had improved, and they were deemed independent. This information was relayed to R1’s Responsible Party(RP) via telephone. A record review revealed no documentation of a re-assessment conducted by the PCP, this was corroborated by an interview with facility staff who stated the PCP observed no change in condition therefore did not complete a new Physician’s Report or document any changes in conditions. At the request of the RP a second re-appraisal was conducted by the PCP on May 21, 2021 that yielded the same results. An outside source interview revealed R1 was given a verbal eviction by the facility ED, stating that they are to move as of the date CHG ceases financial assistance. In contrary, an interview with the facility ED revealed R1 was not being evicted, however their monthly rate would be increasing from approximately $1,217.00, which is fully covered between CHG and SSI, to the private pay monthly rate of $5,000, because the facility does not accept SSI/SSP recipients/payments. A review of the California Advocates Nursing Home Reform (CANHR) Eviction Protection for RCFE’s factsheet revealed pursuant to Title 22 regulations, if the resident is an SSI/SSP recipient the RCFE shall provide basic services at the rate established for SSI/SSP recipients as stated in Title 22 California Code of Regulations.