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13 | This is an Amendment to the original report issued 05/16/2024. Additional information was added to clarify the investigation.
At 10:00am, Licensing Program Analyst (LPA) Angela Panushkina conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPA met with the Administrator and explained the reason for the visit.
During course of the investigation, interviews and record review were made. At 10:05am, LPA requested resident and staff roster. At 10:10am, LPA requested copies of pertinent information which include, but not limited to Admission Agreement, Physician’s Report, Appraisal Needs and Services Plan, Eviction Letter, etc., relevant to the investigation. At approximately 10:15am, LPA conducted a physical plant tour, to ensure health and safety of the residents are protected and physical plant is in compliance with Title 22 Regulations. Continue on LIC9099-C
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| Substantiated | Estimated Days of Completion: |
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NARRATIVE |
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32 | Between 10:20am – 12:30pm, LPA interviewed the Administrator, two (2) staff and two (2) out of six (6) residents, who were able to communicate.
It was alleged that the facility did not accept R1 after hospital discharge. To investigate this allegation, LPA conducted an interview with the Administrator and was informed that upon R1's admission on 04/29/24, the Administrator attempted to arrange home health for R1's wound care. Five (5) Home Health agencies were contacted so that a proper medical care could be provided to R1. However, all five agencies refused/were unable to assign a Home Health to R1 due to insurance coverage limitations. On 05/09/24, was hospitalized and level of care for R1 changed; and therefore, the facility could not accept R1 back to the facility. Upon LPA’s request, the Administrator could not provide sufficient document regarding R1’s changes in the level of care. Additionally, the investigation revealed the Administrator did not submit the Eviction letter to the Community Care Department nor served a copy of 30-day Eviction notice to R1/family/representative.
On 06/13/24, a telephonic interview with R1 revealed that R1 had anticipated going back, however, the hospital doctor stated that R1 requires a higher level of care. No re-appraisal and no conversation with R1 was done by the facility's Administrator to inform that the facility can no longer meet R1's needs based on what the hospital/doctor said. Based on interviews and record reviews this allegation is Substantiated at this time.
Deficiency cited on LIC9099-D
Exit interview conducted, appeal rights explained and copy of this report signed and delivered. |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Request Denied
Type B
05/23/2024
Section Cited
CCR
87224(a) | 1
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7 | Eviction Procedures-The licensee may, upon thirty (30) days written notice to the resident, evict the resident for development of a need not previously identified.
This requirement is not met as evidenced by: | 1
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7 | Licensee will ensure that Title 22 Regulations are followed for eviction procedures. Administrator will send statement that any resident that is evicted will be afforded the ability to go through the proper eviction process. |
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14 | Based interviews and record reviews, licensee did not comply with the section cited above, by failing to properly evict R1. On 05/09/24, R1 was hospitalized and not accepted back to the facility, which poses/posed a potential health and safety risk to persons in care. | 8
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Type B
06/28/2024
Section Cited
CCR
87463(a) | 1
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7 | Reappraisals: (a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical...
This requirement is not met as evidenced by | 1
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7 | Administrator agreed to submit a statement of understanding on how all residents will have a proper reappraisal when changes occur and discharged from the hospital to ensure their needs are met. Proof of statement shall be submitted to LPA by POC date. |
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14 | Based on interview and record reviews, licensee did not comply with the section cited above. Adminsitrator confirmed that upon R1's discharge from the hospital, R1's reappraisal was not updated, which poses/posed a potential health and safety risk to resident in care. | 8
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