Complaint Investigation Report

Allegation: Facility staff do not ensure annual health assessments are conducted for residents in care. Based on interviews with the alleged primary care physician and review of documentation presented the facility used information from a falsified physician's report to determine the level of care needed to meet R1's needs. The assessments completed was based on the original physician's report dated 7/7/2022. The next physician's report is dated 10/1/2024 the signature and length of time resident has been your patient is different from the original. The lengths of time vary on both reports the first is 6/22 to present and the second is 6/23 to present. The PCP was contacted by the department and was told that the encounters for R1 were for June of 2022 and July of 2022. No other encounters were confirmed by the Physician in question.

Allegation: Facility staff falsified residents records. The assessments completed was based on the original physician's report dated 7/7/2022. The next physician's report is dated 10/1/2024 the signature and length of time resident has been your patient is different from the original. The lengths of time vary on both reports the first is 6/22 to present and the second is 6/23 to present. The PCP was contacted by the department and was told that the encounters for R1 were for June of 2022 and July of 2022. No other encounters were confirmed by the Physician in question. The office of the Physician in question denied seeing or billing R1 for services since July of 2022. Therefore the other Physician's reports are questionable to the authenticity of the signatures and the information it contains about R1.

Based on records reviewed and interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of regulations, Title 22 are being cited on the attached LIC 9099D. Exit interview conducted and a copy of this report was given