complaint·February 24, 2025

On the allegation: Facility not providing a refund to authorized representative. It is alleged that during the time Resident #1 (R1) lived at the facility, an organization that provides services to residents as part of a court ordered conditional release program was paying the charged rent for R1 at the facility. Allegedly the facility overcharged by 3 times the monthly rate for the January 2024 rent for R1, overcharged by 2 times the monthly rate for March 2024 for R1, and charged the full rate for April 2024, even though R1 did not live in the facility in April 2024. The allegation states the facility overcharged by approximately $15,000 and are not providing a refund. According to staff interviewed by LPA, the organization providing rent payment for R1 paid the facility after the scheduled due dates and provided the facility random payments not coinciding with fully charged rent amounts for R1 or scheduled due dates. According to facility staff, the effective end date for financial responsibility of R1 ended on 03/20/2024. Staff indicated to LPA that the organization responsible for R1’s rent payments was reached out to by the facility to schedule a meeting to discuss rent billing for R1, but the organization did not agree to a meeting. Staff interviews also revealed that when the facility gets a request for refunds, an email is sent to the facility accountant who processes and issues the refunds. Staff interviewed by LPA on 05/01/2024 indicated that they were unaware if R1 or their representative requested a refund. The LPA reviewed records obtained from both the facility and RP. The facility resident lease agreement for R1 states that R1 is charged a monthly fee of $4,845 beginning on 11/30/2023. This fee consists of an apartment fee of $2,995 and care fee of $1,850 per month for R1. The billing reconciliation document received by the LPA from the facility and staff interview revealed that R1 had $1,000 of community fees upon admission and a pro-rated rent of $161.50 for November 2023. The facility began to charge the full monthly fee to R1 for December 2023. R1 had unpaid rent for November 2023 and December 2023, with late fees of $250 per month added. The document indicates that the facility received payments for R1’s fees in January 2024 totaling an amount of $13,440. R1 was charged late fees of $250 each for January 2024 and February 2024. As R1 was financially discharged from the facility on 03/20/2024, the facility charged R1 a pro-rated monthly rent of $3,230 for March 2024. The reconciliation shows that the facility received payment for R1 from the organization totaling $13,440 in January 2024, $3,500 in February 2024, $3,230 in March 2024, and $3,500 in April 2024. Report will continue on LIC9099-C, 3rd page. According to the facility billing reconciliation document, the monthly fees charged to R1 from admission to discharge totaled $19,926.50 while the payments received for R1 from admission to discharge totaled $23,670. The billing reconciliation document for R1 indicates that there is an excess of $3,743.50. The organization that submitted payment for R1 is entitled to reimbursement for an excess amount of payment to the facility. A review of emails between R1’s authorized person and facility staff revealed that staff acknowledged that a 30-day notice was given and 2/20/24 would serve as Day 1 of that 30-day notice. Therefore, the organization is responsible for 30 days of rent fees from the date of discharge by R1 on 02/20/2024. This means the facility can charge R1 fees until 03/20/2024. LPA received information from the facility that a refund check had been provided to the authorized representative of R1. A check for the full excess amount documented in the billing reconciliation form for $3743.50 was issued in R1’s name on 05/07/2024. The facility was then contacted by the organization paying R1’s facility fees asking for the refund check to be made out directly to the organization, which was done by the facility. Even though a refund had been provided, per the admission agreement; In the event that Resident is absent from his/her apartment for medical care for a period of more than 10 days, $5.00 per day will be credited to the Resident for meals and Care Fees will be prorated and credited to the account commencing on the 11th day until the Resident returns to the Community. Since R1 never returned to the facility after 01/29/2024, R1 and/or their authorized person are still owed meal and care fees for February to April. Based on the information gathered, there is sufficient evidence to prove that the allegation " Facility not providing a refund to authorized representative " occurred. Therefore, the allegation is Substantiated . Per the California Code of Regulations, Title 22, Division 6, Chapter 8, the following deficiency was observed and cited during the visit (See 9099-D). Exit interview conducted. A copy of the report and appeal rights were provided. On the allegation, “Facility not releasing records to authorized representative” It is alleged that even though resident’s #1 (R1’s) authorized person signed “release of information” for R1, the facility is refusing to provide payment records or medical assessment records as requested. LPA requested and received from the facility the Release of Client/Resident Medical Information form that was signed by the authorized representative of R1 on 11/30/2023. The authorized representative of R1 is an employee of the organization paying R1’s facility fees as part of a court ordered conditional release program. The release of client/resident medical information form is a Community Care Licensing Division (CCLD) form typically required when the resident wishes to authorize the release of their medical information to facility staff. This form ensures that only authorized individuals have access to the client's medical information. R1’s representative who authorized the release is entitled to a copy of the release form itself, and residents have the personal right to request documentation from their facility file. Facility staff interviewed by the LPA stated that they have not had a request for copies of R1’s facility file. All staff interviewed by LPA stated they have no knowledge if R1 or their representative have requested any documents. The administrator of the facility stated to LPA that the facility has not received any request for any documentation, the authorized representative for R1 has not requested any billing/payment documents from the facility nor any medical documentation from the facility records/file on R1. There is no evidence through record review of facility documentation or LPA interviews that the facility withheld any of R1’s records from their authorized representative. LPA received email correspondence between the responsible party of R1 and the facility regarding the need for a 30-day eviction notice. On 02/20/2024, the responsible party for R1 emailed the facility and inquired about whether they can terminate the admission agreement for R1 immediately without requiring a 30-day notice so that they would not have to pay the February 2024 facility fees for R1. The responsible party for R1 indicated that they were informed that the facility needed to complete an “evaluation” of R1 to determine whether they would have to pay for February 2024 or they can terminate the lease immediately without 30-day notice. The assessment mentioned in the email correspondence is in relation for the need to have a 30-day notice of eviction. Furthermore, emails revealed that R1’s authorized person later went on to state they have not received the assessment, however, the LPA did not find any request for the assessment. Based on the information gathered, there is insufficient evidence to prove the alleged violation occurred. Therefore, the allegation is Unsubstantiated. Exit interview conducted by LPA. Copy of this report provided to the facility