Casa De Vida Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPA was greeted by, identified herself to, and discussed the purpose of the visit with House Supervisor Shannon (Bird) Conger. All staff that LPA encountered have a current criminal record clearance. LPA conducted a tour of the facility and interacted with staff and residents. In accordance with the Department’s Infection Control, LPA provided technical assistance and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan and Infection Control Plan to include disinfection, screening protocols, and the use of personal protective equipment. No deficiencies were cited or observed on this date. An exit interview was conducted, and a copy of this report and Licensee Rights LIC 9058 (3/22) were left with the House Supervisor, whose signature on this form confirms receipt of these documents.the state’s words, verbatim · CDSS document, Sep 21, 2022

Allegation investigated: Staff did not provide a detailed explanation of additional services or accompanying itemization of charges, in the level of care increase letter to resident.

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to deliver investigative findings on the above listed complaint allegation. LPA was met and granted entry into the facility by Caregiver Shannon Conger to whom was explained the purpose for the visit. Licensee Laurene Atkinson arrived shortly later to join the visit. The Department’s investigation consisted of outside source interviews, and a resident and facility record review. It was alleged that the facility did not provide Resident1 (R1) a detailed list of services and their costs to explain the rate increase due to a change in level of care. A record review revealed R1 was admitted to the facility on May 24, 2018 with a primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD) and a back injury. At the time of admission resident records revealed R1 was oriented and capable of managing their own finances, medical care, and medication management, however R1 was very weak and needed assistance with all activities that required ambulation. Additional resident records revealed, as of September 16, 2019, R1 had a decline in health and required assistance with money and medication management, incontinent care, and some assistance with feeding. A facility record review revealed at admission these additional services were included as basic services in the original monthly rate of $4,000 offered by the facility, except for incontinence care. Substantiated Interviews with outside sources and a record review revealed R1 was provided a letter dated May 24, 2020 stating R1's monthly rate had increased to $5500 due to an increase in level of care. Further review of R1's records revealed the only additional service being provided outside the scope of services agreed upon at intake, per the Admission Agreement, was incontinence care. A review of the notification provided to R1 regarding the increased rate did not include a list of additional services, and their accompanying costs, that R1 required to meet their service needs. The resident record review revealed no documentation notifying R1 what additional services and their associated costs were provided to R1 to support the rate increase as stated in the Admission Agreement. Based on LPA’s records review, and interviews conducted the above allegation is determined to be substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met. LPA Correia conducted an exit interview with Licensee Atkinson at the conclusion of the visit. Signature on this form confirms receipt of the reports (LIC9099), and Licensee/Appeal Rights (LIC9058 01-2016) and per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiency is being cited on the attached LIC 9099-D. This is an amended version of the original report created on August 26, 2022.the state’s words, verbatim · CDSS document, Aug 26, 2022 · control 08-AS-20200713120624

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.657 · Plan of correction due date: Sep 28, 2022

Rate increase due to change in level of care;(a) ...licensee shall provide...written notice of the rate increase...at the new level of care. The notice shall include a detailed explanation of...services to be provided at the new level of care and...itemization of the charges. Based on a record review and interviews the licensee did not provide a written notice of an itemized list of additional services and their accompanying cost to 1 out of 3 residents. This posed a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 26, 2022

Plan of correction: Licensee agreed to attend, along with facility staff, a CCL approved vendorized training course that covers regulations on resident and faciltiy record requirements. Licensee will provide proof of completion by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPA was greeted by and identified himself to caregiver Kathy Hinh. LPA then met and discussed the purpose of the visit with administrator Laurene Atkinson. LPA conducted a brief tour of the facility and observed the residents in care. In accordance with the Department’s Infection Control, LPA provided technical assistance and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan, to include disinfection, screening protocols, and the use of personal protective equipment. No deficiencies were cited on this date. An exit interview was conducted with Atkinson to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail.the state’s words, verbatim · CDSS document, Jul 21, 2021