Complaint Investigation Report

On the allegation: Facility is not following its Admissions agreement on refunds. It was alleged that Resident 1 (R1) was overcharged for bathing and medication assistance, and was overcharged for a month of care before moving out. 7 out of 7 residents stated that they have no issues receiving services at the facility or do they have problems with refunds. 2 residents stated that they requested the facility to remove specific services that they no longer need, and the facility complied with their requests. R1’s physician’s report dated 3/21/2019 indicates R1 can self-bathe when R1’s pain is controlled, and can handle their own medications except if using excess pain medication. R1’s pre-admission appraisal indicates standby assistance for showers and facility will store, manage and help with self-administration of medications and was signed by R1 on 4/16/2019. R1’s assessment indicates stand by assistance with bathing every other day, and for staff assistance with medication, and was signed by R1 on 4/16/2019. R1’s care plan indicates R1 needed physical assistance with bathing twice weekly and for staff assistance with medication. Although R1 refused staff assistance with bathing on multiple occasions, the Administrator stated R1 still needed assistance with bathing due to R1’s physician’s report and care plan, which was agreed to by R1. The Administrator stated the safest way for R1 to shower was with staff assistance. The Administrator stated R1 typically would not shower unless staff assisted R1 with it, despite claims R1 had already showered. R1 refused bathing assistance in July and August 2019 but was still charged for it, because R1’s physician indicated R1 needed assistance with bathing and R1 signed their care plan agreeing to shower assistance.

R1 was charged for medication assistance in November and December 2019. The Administrator stated when a resident is in the hospital, they stop charges for care but they still charge for medication management because the resident still has medications at the facility even if they are PRN medications. The Administrator stated the staff still count the medications including PRNs everyday, and so therefore still charge for medication assistance unless the resident does not have any medications present in the facility. This is also stated in the admission agreement on page 8 under “Absence from the Community.” R1 and their responsible party both signed the admission agreement on 4/19/2019.

R1 was moved from the facility in September 2020 and provided a written 30-day notice on 9/25/2020. R1’s belongings were removed by 9/28/2020. The September 2020 fees were already paid on 9/10/2020, before R1 moved out. The October 2020 fee consisted of a pro-rated room rate only, since no care was provided in October. LPA reviewed the records and determined the facility did not charge for anything after the 30-day notice was up. Based on the information obtained, the allegations are deemed unsubstantiated at this time.