Health inspection·September 11, 2023

F 0567 Honor the resident's right to manage his or her financial affairs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure a proper system was in place to safeguard one of three sampled residents (Resident 1) personal funds when the facility's billing department deposited Resident 1's personal check for rent payment into the facility's bank account. Residents Affected - Few This failure resulted in the misappropriation of Resident 1's personal funds which had the potential to cause emotional distress and anxiety to the resident. Findings: During a review of Resident 1's Face Sheet (FS), dated 8/9/23, the FS indicated in part, Resident 1 was a [AGE] year-old female, who was admitted to the facility on [DATE] with admitting diagnoses including, pneumonia (infection of the lungs) and acute kidney failure (rapid loss of kidney function). The FS also indicated, Resident 1 was discharged from the facility on 10/20/22. During a phone interview on 8/9/23 at 5:25 p.m. with Resident 1, Resident 1 verbalized, asking a facility staff to mail out a personal check as payment for a leased residential property. Resident 1 also verbalized the check was made payable to (name of Resident 1's lease property management) as payment for the month of October 2022. Resident 1 found out the lease property management did not receive the check after receiving a call from them. Resident 1 later confirmed, through her bank, that the check was processed and deposited into an account named after the facility. During an interview on 8/9/23 at 6 p.m. with the Assistant Director of Nursing (ADON), ADON verbalized that the facility's social services department handles all resident requests for mails to be sent out. During a phone interview on 8/9/2 at 6:20 p.m. with an accounts receivable/billing (ARB) staff for the facility, ARB staff recalled, Resident 1's check was endorsed to the facility's billing department and confirmed the check was made payable to Resident 1's lease property management. ARB staff also verbalized, Resident 1's rent check was mistakenly endorsed to be deposited into the facility's bank account thinking it was Resident 1's co-payment for the charges incurred while admitted in the facility. ARB staff further verbalized, that somehow the bank processed the check and the check was cleared. During a review of the facility's policy and procedures (P&P), titled, Protection/Management, Accounting and Records, Notice, and Conveyance of Personal Funds, dated 3/1/18, the P&P indicated in part, (Corporate Name) facilities have established and maintain a system that assures a full, complete, and separate accounting of funds entrusted to (corporate name) facilities on the resident's behalf. Page 1 of 2 555619 555619 09/11/2023 Arroyo Grande Care Center 1212 Farroll Avenue Arroyo Grande, CA 93420

F 0567 The accounting system is established according to generally accepted accounting principles. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 555619 Page 2 of 2