complaint·November 18, 2022

Based on review of R1’s Admission Agreement, it states on page 4 of 10, “The resident is required to stay a minimum of two months. Should the resident leave before the two-month minimum period, the resident agrees to pay the entire monthly fee for the first and second months.” R1’s monthly rent was $4,500 plus an additional $500 a month for hospice care services, a total of $5,000. R1 paid rent for April and May 2022 in the amount of $10,000. On 6/23/2022, LPA interviewed Administrator (ADM) Ronnie Ubungen and ADM's spouse (S1). ADM stated R1 moved in the facility on 04/01/2022, and subsequently admitted into Hospice Care on 04/12/2022. R1 died on 4/26/2022. R1 was at the facility for 27 days including one day when R1’s family picked-up R1's belongings on 04/27/2022. During the initial complaint investigation visit, the ADM has decided to refund $5,850.00 a partial refund for April 2022 and a full refund for May 2022. ADM refunded 4 days in April 2022 ($600), and 15 days ($250) in April 2022 of paid for hospice care. A review of the current Admission Agreement approved by the Department in 2007 (LIC604A with Refund Changes addendum in reference to SB141-Soto and Health and Safety Codes 1569.651 & 1569.665 and 9. Refund Policy, on page 4 of 8) is entirely different from R1’s Admission Agreement. A review of R1’s Admission Agreement under number #4. Billing and Payment Policy -Monthly Rate, on page 4 of 10, “it states that the facility requires resident to stay a minimum of two months and the first two months is non-refundable with no exceptions and should the resident leave before the two-month minimum period, the resident agrees to pay the entire monthly fees for the first and second months.” In addition, under number #5. Refund Policy, on page 4 of 10, “it states that on any subsequent month, in the event of death or sudden illness where resident will require Skilled Nursing Care, a refund will apply based on the anniversary of the admission date based on the following: If it occurs during the 1 st 15 days, ½ of the monthly rate will be refunded and If it occurs on the last 16 th days, no refund will be made.” Continued on 9099-C. Page 2 of 3. Based on interviews, and record reviews, the facility (licensee) has issued or utilized a new Admission Agreement to residents which is subject to Department’s review to ensure it adheres to current policies, regulations and laws on refund policies. A review of R1’s Admission Agreement on page 4 of 10 under #4. Billing and Payment Policy and #5. Refund Policies has conflicting and/or misleading information. The Department has investigated the above allegation. Based on records reviews, and interviews conducted, the preponderance of evidence standard has been met. Therefore, the Department found the above allegations to be SUBSTANTIATED. Deficiency is being cited. See LIC 9099-D. Exit interview was conducted with ADM. This report and LIC9099-D were provided to ADM for signature.