Complaint Investigation Report

The investigation revealed the following: In regards to the allegation that "Facility staff changed clients healthcare provider without clients permission," it is alleged that at least three (3) clients have had their medical provider changed to the in-house facility medical provider without their permission. During interviews with the clients, five (5) out of sixteen (16) interviewed corroborated the allegation. One of the clients interviewed stated that their primary doctor had been changed to the in-house facility provider, and they had no idea how or why the change was made. Another client interviewed stated that their primary provider was also changed to the in-house facility provider, that they had no idea why this was the case, and they believe it was probably the facility staff that made the change. During interviews with staff none of them corroborated the allegation. One staff member explained that they utilize PCP Change forms that are signed by the client and sent to the in-house physician to process the PCP change. Another staff member stated that sometimes they complete the PCP change over the phone with the client's health insurance after the client provides consent to the insurance for the staff member to speak on their behalf. C1, C2, and C3 were identified in the complaint as having had their PCP changed without their consent and corroborated the allegation, and the facility was not able to provide any documentation that describes why the change was made. C13 and and C16 were not identified as potential victims, however they also corroborated the allegation and the facility was not able to provide any documentation providing explaining why their PCP was changed. The facility was able to provide documentation known as "Request for PCP/PPG Change Forms" for C17 - C19, however none of these clients were identified as possible victims in the original complaint report as having had their PCP changed without their permission.

Based on LPA interviews conducted with the clients and staff, the preponderance of evidence standard has been met for the above allegations, therefore the allegation is found to be SUBSTANTIATED . California Code of Regulations Title 22, Division 6, Chapter 1 is being cited on the attached LIC9099D page.

Exit interview was held and a copy of the report along with the appeal rights were provided and will be emailed to the administrator.