The Department requested for R1’s medical documents for review. On 04/07/2022, R1 was transferred to the hospital due to a fall and was discharged same day noting no serious injuries. On 04/08/2022, R1 had a fall and fell onto right hip area witnessed by R2. R1 was transferred to the hospital for further evaluation due to pain. R1 had a resent periprosthetic fracture on right femur admitted in February. R1 has been observed for the following conditions: right hip periprosthetic fracture, now admitted for right hip dislocation. R1 was discharged to a Skilled Nursing Facility. R1 returned to the community on 04/28/2022. R1 was out of the community for 18 days. According to R1’s admission agreement, if you are absent from Meadow Oaks of Roseville for more than fourteen (14) consecutive days, you will receive a pro-rated credit towards your Monthly Care Fee starting on day fifteen (15). No credit is given for an absence that is less than fourteen (14) consecutive days. The facility is responsible to refund RP for the remaining 3 days the resident was out of the community.

On 05/02/2022, R1’s responsible party (RP) gave the facility a 30-day notice via email. Facility received 30-day notice and indicated that R1 and R2 will move-out on 05/31/2022. According to Business Office Director (BOD), Rayna Gabriel, R1 and R2’s RP had moved residents out before move-out date. RP physically moved R1 and R2 out of the community on 05/08/2022. According to complainant, the facility did not refund R1’s RP for the remaining 22 days that resident had officially moved out of the community. According to R1’s admission agreement it states, you or the responsible person shall remain liable for the monthly fee until the later of the date on which this agreement terminates; or the date in which your apartment is vacated and all property removed from it. Interview statement gathered from BOD indicated R1’s RP is responsible to pay for the remaining days although R1 has moved out of the facility. This is facility’s policy and it’s stated in R1’s admission agreement.

The Department requested for R1’s and R2’s ledger for review. R1’s ledger indicated the total amount due for the month of April 2022 is $10,752.90. R2’s ledger indicated the total amount due for the month of April 2022 is $929.03. R1 and R2’s RP sent a check to the facility in the amount of $9645.97. The facility used the check to pay R2’s fee of $929.03 and the remaining amount was paid towards R1’s fees.

Due to this information CCL finds the allegation to be SUBSTANTIATED. – A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Deficiencies are cited on the attached LIC 9099-D.

Appeal rights were provided.

An exit interview was conducted, and a copy of the report left at the facility.

Interview statement gathered and received from Complainant indicated, there were no staff to assist R1 in April and May of 2022. Complainant stated resident requires a two- person transfer. Complainant expressed concerns that residents needs services were not met. On 4/1/2022, Complainant was at the facility and observed R1 alone on the toilet with no care staff in sight. Complainant pushed call button and S3 arrived. S3 was there to assist in changing R1 without another staff to assist. Complainant explained to S3 that R1 requires two-person assist and that R1’s leg was broken. Second staff did not show up to assist and complainant had to assist S3 with changing R1.

Interview statement from S3 confirmed that complainant was present at the facility and helped S3 with assisting R1 in changing into new brief and transferring R1 to a wheelchair. S3 stated S3 was not aware R1 was a two-person assist and received assistance from complainant. S3 stated if care staff needed assistance transferring R1 care staff can use a walkie-talkie to call for help.

The Department requested and reviewed R1’s level of care assessments. The facility conducted R1’s initial move-in assessment on 04/03/2022. The level of care assessment indicated R1 needs assistance with grooming, bathing, dressing, medication, toileting, and transfers. R1 requires 1-person assistance. On 05/03/2022, the facility conducted a 30-day evaluation. The 30-day evaluation level of care assessment indicated R1 requires 1-person assist with grooming, bathing, dressing, medications, transfers, and toileting.

The Department gathered interview statements from facility staff (S). S1 indicated the Villa in Memory Care unit has one (1) staff scheduled to provide care and supervision during the NOC shift. S1 stated facility policy of staff ratio in the Villa is one (1) staff per ten (10) residents. S1 stated during the time R1 resided at the facility the Villa had less than ten (10) residents. S1 assisted R1 in repositioning every two (2) hours. Interview statement gathered from S2 indicated during the PM shift two (2) staff would assist R1 and during the NOC shift one (1) staff would assist R1. S2 stated staff would conduct rounds every two (2) hours. S2 confirmed that there were six (6) residents total that resided in the Villa during the time R1 was at the community. S2 assisted R1 with repositioning. S2 stated there has been multiple occasions where R2 would try and assist but was told not to assist to prevent injuries. S2 stated R1 was not able to walk on their own but would try to walk and care staff would try to redirect to prevent a fall.

Due to the information above, LPA finds the allegations to be UNSUBSTANTIATED meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.