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32 | CONTINUED FROM FORM LIC9099
Regarding the allegation that Facility is not providing services pursuant to contract, the following has been concluded:
Resident R1 was admitted to the facility on September 28, 2021. Following issues involving the resident's Long Term Care Insurance claim, payment of the resident's accrued facility fees ceased in 2022, causing the former facility administrator to issue a 30-day eviction notice on September 15, 2022. Facility has not followed up with filing an unlawful detainer at this point. Following the continued accrual of late fees, facility took the decision to discontinue optional services provided at additional charges to the base service rate, i.e. providing room service for meals as well as staff-provided laundry service.
At the time of the follow-up visit, past due fees are stated to be in the amount of $26,094.96. The Long Term Care insurance claim for resident R1 had to be filed again after her Needs Assessment reevaluated the resident as requireing assistance with two Activities of Daily Living. However concerns with the ability of the resident to follow up with the claim remain.
However, interviews with the resident as well as four staff members, along with a review of records conducted during the two unannounced facility visits confirmed that all other services indicated in the basic service rate in the resident's signed agreement are still being provided to resident R1 as contractually indicated in the resident's admission agreement, reviewed during the investigation.
Therefore, the allegation that Facility is not providing services pursuant to contract is deemed to be Unsubstantiated, meaning that although the allegation may have happened or is valid; there is not a preponderance of evidence to prove that the alleged violation occurred as reported. |