complaint·May 30, 2025

It was discovered in an interview with Facility Administrator, Robin Murray, on 04/30/2025, and email on 05/05/2025, that she had recalled, “Approximately in late November 2024, Mr. Grover, (Chris Grover, PT) came into the community and introduced stating that he worked next door (Lompoc Skilled Nursing & Rehabilitation [SNF]) and wanted to know if we (Fountain Square) had anyone who needed outpatient Therapy services. Administrator also stated that, Mr. Grover was introduced to the facility, Resident Care Coordinator (RCC), and was informed to always check in with the RCC as many family members are the Resident's decision makers. Administrator also stated, “one encounter, I was informed from my staff that he was only seen a couple of times, and for less than a five-minute period. One time I saw him walk in and looked for him and he had already left the community.” Administrator stated that they communicated with the Skilled Nursing Facility (SNF) next door as to PT being conducted by Chris Grover and it was determined that Mr. Grover was not an employee of the SNF, but a per Diem therapist. Administrator stated that they made a phone call to Chris Grover (date unknown, during the month of February 2025), telling him, “I told him we have no vendor contract with him, there is no solicitation in our community or generally in ALs as well, and that he is not allowed in the community.” On 05/02/2025 and again on 05/09/2025 Licensing Program Analyst Jeffries (LPA) reviewed all facility resident and visitor sign in logs dating from November 15, 2024, through January 20, 2025, provided by email on 05/05/2025 by Administrator, and noted that there were zero sign-ins by Chris Grover during that time period. LPA also noted that all visitor sign-ins to see R1 were all sign-ins by family members of R1 with no other noted visitors for R1 on the facility sign in logs during that time period. On 05/29/2025 LPA contacted Administrator by phone to confirm that all sign-in by the name “Chris” or “Christopher” were not Chris Grover, this was confirmed by email on same day. LPA Jeffries reviewed R1’s medical billing from December 9, 2024, though January 4, 2025, with 12 physical therapy visits billed to R1 resulting in a total of $5732.19; $2215.60 paid to Chris Grover; $2956.92 paid by insurance companies; and $559.67 paid as a co-pay fee. LPA noted that these invoices indicated that they were authorized by Doctor #1, who is R1 attending Physician. On 04/30/2025 LPA Jeffries conducted an interview with R1 Power of Attorney (W1) who stated that they had contacted Doctor #1’s office to determine if there was an authorization for Physical Therapy Services. W1 stated that Doctor #1’s office denied authorizing PT referral and had no documentation indicating those PT services were authorized through Doctor #1’s office. W1 state that they did not know who Chris Grover was, and as POA to R1 did not authorize him to conduct PT services at any time. CONTINUED on LIC9099-C W1 stated that they do not know how Chris Grover knew who R1’s Primary Care Physician was but suspected that the missing Medicare card, and Administrator stating to W1 that Chris Grover had been seen coming out of R1’s room. W1 stated that R1 receives PT through the Veterans Affairs Office (VA) outside of the facility. On 05/29/2025, LPA Jeffries conducted a phone interview with Resident 2 (R2) family member (W2) and POA of R2, who stated that, Chris Grover billed R2 for 13 sessions of PT that were unauthorized. W2 stated that they called R2’s primary care physician, Doctor #2, who was listed as the referring Physician, who stated they did not authorize any PT session to Chris Grover. W2 stated that the facility helped them dispute the charges but as of 05/29/2025 have not received any verification if those charges were refunded. W2 stated that they did know Chris Grover and did not authorize him to provided PT services to R2 at any time. W2 stated that they did not know Chris Grover and not know how he knew personal or medical information of R2. W2 stated that Chris Grover did speak with R2 briefly in the facility but did not know or recall what information was shared. LPA observed facility communication record to Doctor #2, dated 04/30/2025 requesting PT referral for R2, with a response of, “Do not have a record of this.” LPA noted that two residents (R1 and R2) both have a diagnosis of cognitive impairment and have different primary physicians. On 03/17/2025, at 4:00pm, 04/03/2025 at 12:15pm, and 04/30/2025 at 9:00am LPA Jeffries entered the facility unscreened by staff, and had to walk the halls of the facility to find staff in order to check into the facility. Based on, interviews, observations, documentation of facility log-in records that had no record of sign-in of Chris Glover, in which his presence at the facility was confirmed by Administrator statements and emails, observations of LPA on 3 facility visits of no staff to screen who is entering or exiting the facility, documentation of fraudulent bills for R1 and R2, and documentation of different residents detailed medical information in flatulent billing invoices. Due to lack of staff screening the entrance to the facility, reasonable efforts to safeguard resident property (and medical information) were not made and therefore, there is enough evidence at this time to support the allegations of “Staff did not prevent resident from being financially exploited.” and “Staff did not safeguard resident's personal belongings.” and are both substantiated at this time. Exit interview, report read, citations issued, appeal rights and report provided.