complaint·May 30, 2025

Continued from 9099... head. Case Manager arrived at the facility at 0945 advising facility that hospice was on the way. After hospice team arrived, they made the decision to have R1 sent to the ER by ambulance. LPA’s review of chart notes indicate that R1 experienced an injury unrelated to the reasons for which they were on hospice. However, facility waited almost 2 hours, with R1’s head continuously bleeding, before sending to the hospital. Additionally, the facility waited for hospice to make the determination to send to the hospital, they themselves did not make the determination. Based on LPA’s record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D. Complaint alleges facility staff did not ensure resident’s room was maintained clean. Complainant alleges facility did not properly clean R2’s room and that remnants of fecal incontinence were left unattended. During investigation, LPA reviewed Administrator’s email pertaining to the cleaning of R2’s room, email shows that Administrator acknowledged that staff needs to “clean things up much better.” Additionally, in email, Administrator acknowledges that “if maintenance is not available to clean up, then the facility needs to find another person that can clean up right away.” Based on LPA’s record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D. Complaint alleges facility staff did not provide notification of or explanation of services to be provided at the new level of care to resident's responsible person and that facility staff did not provide an itemization of charges to resident's responsible person. During investigation, LPA reviewed billing statements provided to R2’s responsible party from the facility. LPA also reviewed email exchange between facility’s Health and Wellness Director (HWD) and R2’s responsible party. Increase in charges for new level of care were implemented January 1, 2025. However, R2’s responsible party claims they were not made aware of the changes in level of care needed nor that a new level of care was being provided. LPA reviewed R2's three most recent care plans and found care plan from December 24, 2024 to indicate increased level of care needed for R2. However, none of the care plans were signed by R2’s responsible party. Facility did eventually provide Continued on 9099C(2)... Continued from 9099C... explanation of fees and itemization of fees to resident’s responsible party on January 26, 2025. However, facility could not show or provide LPA with proof of initial notification. Per Health and Safety Code 1569.657(a), any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate increase within two business days after initially providing services at the new level of care. The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges. However, facility could not provide LPA proof of notification sent to R2's responsible party within two [2] business days after initially providing services at the new level of care. Based on LPA’s record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given .