Complaint·June 25, 2024

On 06/17/2024, LPA Cortez conducted a subsequent visit, conducted a record review and staff interview. On 06/18/2024 LPA Cortez conducted staff interviews and obtained pertinent documents. During today’s visit, LPA Cortez delivered findings. Staff did not ensure that resident's toileting needs were met. On the allegation that Staff did not ensure that resident's toileting needs were met , the reporting parties concern is that staff did not respond timely for calls for assistance with toileting, and as a result Resident#1 (R1) would have accidents and wet themselves. To investigate the allegation, file review and interviews were conducted. Staff interviews revealed that when the facility is short staff, residents can go without showers and additionally staff interviews revealed that due to being short-staffed staff would not get to R1 timely and R1 would sometimes be wet when they got to R1. Furthermore, staff interviews revealed that if staff is busy it can take up to forty-five minutes to an hour to assist residents when they pressed their pendant. Record review conducted revealed that on numerous occasions it took longer than 30 minutes for R1’s call button to be answered. During December 2022, R1 had approximately 28 pendant calls that took approximately 30 minutes or longer to be answered, with one pendant call on December 31, 2022 taking approximately one hour and forty-two minutes to answer. Lastly, on 06/18/2024, at approximately 1:50 p.m. LPA Cortez heard staff calling for assistance from other staff to assist with a resident transfer over the radio for over twenty minutes. The staff's call for assistance went without being answered for approximately over twenty (20) minutes. Based on interviews, file review, and observation, the above allegation is deemed Substantiated at this time. Staff billed resident for services not received. On the allegation that Staff billed resident for services not received, the reporting parties concern is that per the admission agreement after a resident is out of the community for fifteen consecutive days a credit/refund for personal care would be issued, and staff charged Resident#1 (R1) for personal care for days R1 was at the hospital, at a skilled nursing and not in the community. It was further reported that R1 was taken to the hospital on January 5, 2023, and did not return to the facility until January 27, 2023. To investigate the allegation, record review and interviews were conducted. The LPA reviewed R1’s admission agreement which states the following: D. Adjustments to Fees or Services. 3. Absences from Sage Mountain Senior Living. If you are absent from _ Sage Mountain Senior Living for a period of fourteen (14) consecutive days or more, you will be entitled to a credit beginning on the fifteenth (15 th ) day of absence in the amount set forth in Appendix A. Report will continue on LIC9099-C (3RD PAGE). In addition, information obtained during the investigation revealed that R1’s authorized person had inquired with Business Office Manger Jennifer Miller on May 23 rd of 2023 via email correspondence about a credit due for the time R1 was absent from the community (1/05/2023-1/27/2023) and Miller stated they would check the dates with staff and verify if a credit was due. On May 31 st of 2023, R1’s authorized person requested an update on the credit potentially due, to which Interim Administrator at the time, Julius Osorio was cc’d on and corresponded that they would try to follow up on and provide an update. Staff interviews revealed that yes, depending on the resident’s admission agreement, if a resident would be out for a period of fourteen (14) consecutive days, residents would be entitled to a credit or refund starting on the fifteenth (15 th ) day of absence. Interview conducted with Julius Osorio, revealed that they never followed up with R1’s authorized person and did not ensure they received their personal care credit they were inquiring about. Staff interviews revealed that Business Office Manager, Jennifer Miller is no longer working at the facility, and it would have been their responsibility to follow up regarding this credit/refund. Staff interviews also revealed that due to the company’s management change that took place in 2023, the new management company, Agemark, does not have access to financial records for January 2023 for residents who are no longer at the community, staff were not aware of any pending refund/credit due to R1 or R1’s authorized person, and staff do not know if R1 and/or R1’s authorized person received a credit/refund for the dates in question. Additionally staff were not able to provide R1's financial records for January 2023. Financial records that were provided for May and June of 2023 revealed that R1’s authorized person received a refund, however the refund was not pertaining to the personal care credit/refund in question. Based on interviews, and file review, the above allegation is deemed Substantiated at this time. Pursuant to Title 22, California Code of Regulations, the following deficiencies are cited (refer to LIC 9099-D). Exit interview conducted, appeal rights discussed, and a copy of this report issued.