It is alleged that staff do not ensure residents medical needs are met. Regarding this allegation is it reported that Client #1 (C1) does not have primary care physician (PCP) and due to this facility staff have not taken C1 to doctor appointments, causing C1 to go without primary care. Interview with Administrator revealed that C1 did not have a PCP due to a delay with C1’s insurance carrier. C1 has insurance approved but not an insurance plan so that a PCP can be assigned to C1. Administrator stated that they are working with Department of Children and Family Services (DCFS) case worker to establish a PCP, however in the interim C1 has received care by numerous providers. DCFS case worker had been actively trying to get C1 additional funding through DCFS for PCP coverage, but at no point was C1 without care. DCFS case worker has been made aware of C1’s care the entire time and is well aware of the insurance coverage delay. LPA contacted DCFS case worker and case worker corroborated what Administrator stated. C1 has not gone without care and has been seen by numerous doctors to provide care, to include medical, dental and psychiatric care. LPA reviewed C1’s records that revealed C1’s insurance coverage and a statement that indicates that C1 does have a delay in insurance plan coverage. Additionally, Administrator provided documentation that reflects C1’s numerous visits to receive medical care confirming that there has not been a lack of ensuring that C1 receives medical care. Therefore, based on interviews, observations and record reviews this allegation is deemed unsubstantiated.

Continued on LIC9099-C

It is alleged that C1 has missed medication. Regarding this allegation it is reported that due to C1 having two different psychiatrists, medication prescribed by one psychiatrist has not been given to C1. Interview with Administrator revealed that C1 has had a dedicated psychiatrist from North Los Angeles Regional Center (NLARC) from day of Admission to facility. Administrator states that the missed medication is not missed medication, but instead was a prescription issued by another psychiatrist that was assigned to C1 once he was released from the hospital. However, C1’s dedicated psychiatrist advised Administrator that the medication was not needed and would interact with C1’s current medication. Furthermore, Administrator revealed that the hospital psychiatrist is upset at facility because they cannot bill for their services since C1 already has a dedicated psychiatrist, making this more of an insurance concern rather than missed medication. LPA spoke to DCFS case worker for C1, and case worker indicated that this seems more like an insurance issue considering that C1 has been seen by multiple doctors. Case worker further indicated that NLARC provider has been with C1 for some time and is the provider whose instructions should be followed, to include that other medication prescribed should not be taken by C1 due to interaction with current medication. LPA reviewed medication logs, and they reflect that all prescribed medication has been taken as indicated by C1’s dedicated psychiatrist. Therefore, based on interviews and record reviews this allegation is deemed unsubstantiated.

No citations issued. Exit interview conducted. Copy of report provided to Administrator.