Complaint·February 6, 2023

Interview with R2’s family member stated that they were not made aware of any physical therapy order for R2 until they received a phone call from a nurse at Heart 2 Home Health stating that they saw R2 that day. Interview with Los Robles Home Care Services staff revealed that R1 was discharged from PT on 12/4/19. Interview with R1’s physician’s office revealed that they did not refer R1 for physical therapy in 2020. Interview with Licensee/Representative revealed that Dr. Masongsong is the doctor that goes to their facility to see their residents. Licensee/Representative stated that Dr. Masongsong refers residents to Innerjoy Home Health as well as other places. A review of R1’s records on 7/28/22 starting at 12:52 pm revealed that R1’s Health Insurance approved Physical Therapy for R1 on 2/18/19, 2/25/19 and 11/13/19 with Los Robles Home Care Services. On 11/10/2020 facility staff faxed R1’s physician requesting a doctor order for physical therapy. Facility received an order for physical therapy to evaluate and treat R1 on 11/10/2020. On 11/24/2020 R1’s responsible party received notification of denial of medical coverage from their Health Insurance which indicated that Inner Joy Home Health asked if they could have physical therapy services and they are a non-contracted provider. They denied the request and approved PT services with a contracted provider Los Robles Home Care Services. A review of R2’s records revealed that on 3/20/21 Dr. Masongsong ordered HH (Innerjoy) to evaluate R2 for physical therapy. Based on the information obtained during the investigation, the allegation that the facility did not inform responsible party regarding change in resident’s physical therapy is substantiated at this time. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 9099-D): Exit interview conducted, reports and appeal rights were reviewed and printed.