Complaint·November 21, 2024

On the allegations "Facility is overcharging resident and resident was not provided an itemization of charges."; it is the concern of the reporting party that starting 09/12/24 Resident #1’s (R1’s) cost of care would increase to $6,000 from $3,100 and it is unclear how R1’s care plan justifies the $6000 cost. RP further reported that R1 and/or their authorized person had not received any additional information from facility staff or an itemization of the charges. To investigate the allegation the LPA conducted interviews and a file review. Interview conducted with current Executive Director (ED) Christian Castillo revealed that when the new management company, Agemark, took over about a year ago, it was decided that the community would be implementing new prices for the care costs. The community did not want to scare the residents with the new prices, therefore residents were notified of the new care cost and those residents who were receiving care were given the option to either put a freeze on their account or give them a concession and in six (6) months after the concession was given the resident would start paying the new prices. If the resident opted to have their account be placed on a “freeze”, it meant that they would continue to pay their current rate and not be charged the new care rate up until their new re-assessment or a change in condition. If the resident opted to get a concession, it meant that they would get an allowance care discount on their on their bill and the discount would vary from resident to resident. File review revealed that R1 was sent a letter, dated 02/01/2024, informing them of changes to the community’s level of care system. On that letter it was explained that “All existing residents (anyone who has moved into a community before February 1, 2024) will switch to this new care-level plan on April 1, 2024. The actual change will occur at a resident’s first regularly scheduled assessment or change of health condition assessment after April 1, 2024.” File review also revealed that an additional letter dated 02/06/2024 was sent out with detailed information on the number of points that fit into each care level along with the cost per care level. The community now had four level of care plans and one custom care plan for residents who received 4201 points or higher. Furthermore, file Review revealed that R1 was receiving an allowance care discount of approximately $1200 starting in January of 2024, and on November 12 th of 2024 the changes of the new level of care system took into effect for R1 and the allowance care discount was removed. Based on R1’s assessment conducted on 09/10/2024, R1 was assessed at 6.568.50 points and per the new care-level plans was now receiving a custom level plan and was capped at $6000. Based on the information gathered through interviews and file review, the allegations Facility is overcharging resident and resident was not provided an itemization of charges." are deemed Unsubstantiated at this time. Exit interview conducted and report provided.