complaint·May 22, 2025

It was alleged that staff are prohibited from assisting residents with feeding, including Resident #1 (R1) and Resident #2 (R2) who reside in the facility’s memory care unit and are receiving hospice care services. During the initial complaint visit, LPA interviewed multiple staff, Administrator and Corporate office representative. All employees interviewed indicated this facility does not assist residents with feeding. ED indicated all families are aware of the Atria policy and the facility’s Admission Agreement indicates Atria does not provide these services. Review of Acceptance and Retention criteria revealed that residents “must have the ability to feed him or herself.” LPA reviewed the Admission Agreement signed by R1’s representative, which does include the attachment referenced, however, the Admission Agreement that was submitted to Community Care Licensing Division (CCLD) upon licensure does not include this Attachment nor any policy indicating residents must be able to feed themselves. LPA confirmed with ED that the facility’s Admission Agreement and current related policies have not been sent to nor approved by CCLD. Interview with ED and corporate representative revealed that the facility is not staffed to assist with feeding residents and residents in the facility need to be able to feed themselves or have a private caregiver or family member to assist with resident’s feeding. ED reiterated that facility staff do not assist residents with feeding. Corporate representative stated that if a resident declines and requires any of the services Atria does not offer, as outlined in the Acceptance and Retention Criteria (such as puree food, thickened liquids, or feeding assistance) that the facility staff may assist the resident for up to 30 days while an eviction notice is served to the resident. However, interviews conducted during the initial complaint visit revealed that staff have been instructed not to assist with feeding, as it is against policy. None of the care staff interviewed mentioned they are able to assist with feeding temporarily while a resident is relocated. Instead, all care staff interviewed stated they have been instructed that assisting residents with feeding is against policy. As far as R1, ED stated that R1 passed away under hospice care, but near the end R1 had a private companion to assist in feeding R1. Record review revealed that in a fax dated 09/20/2024, facility staff communicated to R1’s hospice care provider “[R1] needs to be fed by care staff or else [R1] won’t eat.” However, interview revealed care staff are not allowed to assist residents with feeding. In the case of R2, ED stated that R2’s family member is present for 2 (two) meals a day 6 (six) days a week and when R2’s family member isn’t present, R2 will still pick at their food. Interview with R2’s family member revealed that they assume the staff are spoon feeding R2 when the family member is not present at the facility. R2’s family member appeared to be unaware of Atria’s policy related to feeding. Staff did state R2 will sometimes feed Report Continued on LIC 9099-C themselves if the food is placed in their hand, but staff have been reminded this is not allowed per Atria policy. Review of Atria plan of operation revealed that “the community must provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself…The community must provide this assistance and cannot delegate this care to family members, private duty personnel, outside agencies, etc.,” which is consistent with Title 22 Regulation. Both ED and corporate representative interviews revealed the facility is delegating ADL care such as feeding to private duty aides and family members, contrary to the facility policy. ED also stated that per ED's conversation with corporate, that changes to both the Admission Agreement and facility’s policies related to feeding and care services offered were not submitted to CCLD for approval. Based on interview and record review, the preponderance of evidence standard has been met, therefore, the allegation “staff are not assisting residents with feeding” is deemed SUBSTANTIATED at this time. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiency is cited (refer to LIC9099-D). Exit interview conducted, appeal rights discussed, and a copy of this report was provided.