complaint·September 5, 2023

in a one bedroom in Assisted Living with a level care B. Per Addendum B of the Admission Agreement, Level Care B is for residents who require supervision/oversight for hygiene, grooming, dressing and bathing in the form of cueing and prompting; laying out clothes. Review of the Tenant Ledger for noted resident shows that resident was charged per the 8/1/2022 Addendum A at move-in. Review of Physician’s Report dated 8/29/2022, reveals that resident is able to bathe, dress, toilet and groom themselves, can manage medications and cash resources and is ambulatory. Per staff interview and review of updated Needs and Services plan, resident was reassessed in November 2022 at resident’s request resulting in their Level of Care being changed to a level A which includes monitoring food liked, dislikes and intake amount but is otherwise independent. Per the Tenant Ledger, resident began being charged for the change in December 1, 2022. It is not clear on the Needs and Services plan if resident was reassessed immediately following the 8/29/2022 Physician’s Report but care level fee was not updated following the report despite resident’s documented care needs changing significantly. Facility overcharged resident for care services – Based on above and rate discrepancy the resident was overcharged because there is not a documented reassessment immediately following the 8/29/2022 Physician’s Report, which would also initiate a change in care level fee. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) are found to be SUBSTANTIATED. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Angie Smith and Appeal rights were given.