Complaint Investigation Report

Allegation: facility is overcharging resident for rent.

The complaint allegation alleges that the facility is charging residents over the SSI/SSP amount.

During record review at the facility, the department received and reviewed R1’s Admission Agreement that states the basic services monthly rate is $1,398.07 and was agreed upon by the Responsible Party. According to the Non-Medical Out-Of-Home Care (NMOHC) Payment Standard for Individual-Licensed Facility the amount payable for Basic Services is $1,398.07. Additionally, in the Admission Agreement on page 10, the department reviewed the Addendum To Monthly Rate Increases, that states “on or before January 31 st of each year, this facility shall prepare documents disclosing its average monthly rate increase at the average percentage of increase, for the service fee.” The addendum was signed and agreed upon by R1’s Responsible Party on 05/21/2024. The department received and reviewed the notice provided to R1’s Responsible Party regarding the rate change for 2025 to the amount of $1,420.07 for amount payable for Basic Services. Which is the current NMOHC Payment Standard for individuals in licensed facilities. The department additionally received and reviewed a copy of the Monthly Payment Log for December and January and observed residents who are part of the Assisted Living Waiver Program pay the amount payable for basic services.

During interviews with Staff S1-S3, were asked if there are any residents who are on the Assisted Living Waiver Program and use their SSI to pay the difference