Complaint Investigation Report

It was alleged that facility is trying to persuade resident and/or their responsibly parties to change physicians or home health agency to one’s preferred by administration. It was reported that certain home health companies and physicians are self-referring clients for money and having facilities change the resident’s Primary Care Physician (PCP). Interviews conducted with staff revealed that many residents that are admitted to the facility have come from other neighboring facilities. These residents when admitted to the facility already have a PCP which they utilize. Additionally, staff added that sometimes family members may ask for a local doctor to establish care for their family member when the resident is hard to ambulate or be taken out of the facility. In which, the facility provides a list with different doctors in the area and a contact number. However, it is ultimately the family’s choice as they call themselves to get more information and decide between what the insurance covers and which provider can meet the needs of the resident. Interviews with staff further revealed that residents discharged from the hospital already come with a home health agency that their doctors recommended. If a resident requires any service from a home health agency, the facility contacts the resident’s PCP, and they will assign whichever home health agency they use or is covered by their insurance. Interviews conducted with family members revealed that they have not felt pushed or forced to select a certain doctor or home health agency by the facility. Family members stated that the resident’s doctor has not changed in years and added that it would not change even if the facility suggested it. Interview conducted with resident revealed that changing doctors was a decision made only by themselves and no one else. Furthermore, resident denied the facility persuaded them to making that change at any time while living at the facility. Based on the information obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “facility is trying to persuade resident and/or their responsibly parties to change physicians or home health agency to one’s preferred by administration”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No citations issued. Report was reviewed and a copy was issued.