complaint·October 30, 2024

LPA Ng interviewed RP and confirmed the story that was provided on the initial complaint. LPA was able to interview S1 and it was stated that the facility used a different insurance, an in-house medical insurance provider. RP stated R1's insurance got changed without any apparent reason. S1 tried to fix it, and later found that a family member (F1) changed the insurance without notifying S1 and the staff. F1 somehow told S1 that he/she wanted to use some other insurance. S1 explained to F1 that if he/she used some other insurance, then R1 could not use the insurance, that sent physician and nurse to the facility. If R1 used other insurance, then R1 had to travel to clinic or hospital to receive medical assistance. It would not be ideal since R1 was in wheelchair, that R1 might have to travel by taxi to see the doctor. That was why S1 tried to persuade F1 to use the insurance instead. There was no lapse that R1 did not have a time that there was no insurance to receive medical assistance. LPA Ng also interviewed three residents. Two out of three (R2 & R3) mentioned that they had no problem with insurance that it was not changed. R1 stated he/she was not aware that the insurance was changed or his/her representative not being notified. For the residents medical care, R1 stated he/she saw the doctor recently but did not have any note from the doctor. R2 stated he/she got assisted getting medical care from the facility. R3 stated he/she had his medical visit about 2 weeks ago and also got medicine prescribed. A staff member (S2) was also interviewed and stated that if a resident did not have insurance, the facility would help that resident to find one. So no insurance, no issue. S2 also shared that he/she was not aware of any resident not being assisted in the facility because of insurance or any other kind of problem. Based on interviews, the department has determined that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Report is reviewed and copy is provided. page 2 of 2 When S1 was interviewed, S1 stated he/she had every residents' money including R1's money in his possession. S1 mentioned that F1 stopped sending money to R1 recently. R1 currently used the Life Freedom Card that was managed by BMC (Benefits Management Corporation) to buy the things R1 needed. According to the LIC 405 (Record of Client’s/Resident’s Safeguarded Resources) for R1, the logs shows that from 10/9/2017 to 1/11/2019, R1 was receiving $100. Starting from 2/14/2019 to 7/20/2021, different amounts have been received ranging from $37-$161. This was also audited by LPA Ng and it didn’t have any discrepancy. The document also shows how much money was given to R1 upon request and countersigned by S1 and R1. Based on interviews & records review, the department has determined that that the allegations were false, could not have happened and/or is without a reasonable basis, therefore the allegations are UNFOUNDED. Report is reviewed and copy is provided. page 2 of 2