Inspection Reports for Meadow Oaks of Roseville

The inspection was a case management visit conducted by Licensing Program Analyst Kevin Mknelly to review a recent death notification and discuss another resident issue unrelated to the incident.

No deficiencies were noted as a result of the inspection. The Licensing Program Analyst reviewed resident records and interviewed facility staff, including the administrator and resident care director.

The visit was a case management monitoring inspection conducted to deliver complaint findings related to an incident report received on 08/08/2025 regarding a resident fall with injuries.

No deficiencies were noted during the inspection. The Licensing Program Analyst will continue to gather additional information.

The visit was triggered by a complaint involving an incident report about a resident (R1) who had a fall with injuries. The complaint findings were delivered during this visit.

The visit was a non-compliance conference held to review the status of the facility's compliance plan established on 02/06/2025, focusing on ongoing non-compliance issues and medication errors identified in March 2025.

The report details continued incidents of non-compliance related to previous findings, including medication errors and issues identified in monthly audits such as communication with physicians, medication records, and medication refills. The licensee agreed to submit amended quality assurance policies and procedures to address these ongoing issues.

The inspection was conducted as a case management visit following receipt of an incident report regarding a medication error involving resident R1 on 3/26/25.

The investigation found that resident R1 received a discontinued medication, hydrocodone, which had been stopped due to adverse effects. The error was due to lapses in communication and documentation policies. No adverse effects were noted for the resident. Deficiencies were cited posing immediate and potential health and safety risks, and a civil penalty was assessed.

The visit was complaint-related due to an incident report of a medication error involving resident R1 on 3/26/25. The error was substantiated as resident R1 received a discontinued medication. Hospice was notified and no adverse effects were reported.

The visit was conducted to review a recently reported incident involving a medication error reported on 3/20/25 related to an event on 3/14/25.

A medication technician mistakenly administered a blood pressure medication twice in one day to resident R1, resulting in increased monitoring and emergency responder involvement but no hospitalization. Four falls by resident R2 were also discussed, with no deficiencies cited for that issue. Deficiencies were cited related to medication administration and assistance with self-administered medications.

The visit was complaint-related due to a medication error incident reported on 3/20/25 involving resident R1 on 3/14/25. The medication error was substantiated with a deficiency cited.

The visit was a case management and complaint investigation related to an incident report received on March 6, 2025, concerning a resident (R1) who left the memory care enclosed patio by climbing over a fence using patio furniture.

The investigation found that the door alarm batteries were low and caregivers did not hear the alarm when R1 exited. R1 scaled the fence, fell, and received medical assistance for an abrasion. Internal communication failures and inadequate staffing to meet R1's care needs were also identified, posing an immediate health and safety risk.

The visit was complaint-related, triggered by an incident report regarding R1 leaving the enclosed patio unsupervised, resulting in injury. The complaint findings were delivered during the visit.

The visit was a case management visit conducted to review an amended report from 01/14/2025 regarding an incorrectly cited deficiency related to Advanced Directives and Requests Regarding Resuscitative Measures.

The previously cited deficiency was removed from the 01/14/2025 report and re-issued correctly. The plan of correction for the deficiency has been completed, and no new deficiencies were noted during this inspection. A medication error from 01/31/2025 was reviewed, with supervisory action initiated and no harm to the resident.

The visit was an unannounced office inspection conducted due to significant deficiencies noted at the facility from May 2024 to present, leading to a Non-compliance Conference.

Significant deficiencies were identified related to administrator qualifications, incidental medical and dental care services violations, personal rights violations, communication systems and audits, staffing and staff training, and observation of resident change in condition procedures.

The inspection visit was conducted as a case management meeting to assist in resolving outstanding plans of correction related to previous citations.

No deficiencies were noted during this inspection. The Licensing Program Analyst and Regional Clinical Specialist discussed outstanding plans of correction and reestablished timelines for their submission.

The inspection was an unannounced annual inspection conducted to evaluate the health and safety compliance of the facility using the CARE inspection tool.

The facility was toured with no immediate health, safety, or personal rights violations observed. However, 3 of 6 resident service plans lacked signatures for review, and 1 of 5 staff files lacked required dementia care training documentation, resulting in a cited deficiency.

The inspection was conducted as a case management visit following a death notification of resident R1, to investigate the circumstances surrounding the resident's passing and review related records and care.

The department found that the resident exhibited changes in condition and had missed several prescribed medications for three days prior to hospitalization. These changes and missed medications were not reported to the resident's physician, and assistance for medical care was not provided, posing an immediate health and safety risk.

The visit was complaint-related following a death notification for resident R1. The complaint investigation found that the resident's changes in condition and missed medications were not reported to the physician, and assistance was not provided. The resident's death was unexpected and not under hospice care.

The visit was conducted as a case management investigation to deliver incident investigation findings related to a resident's fall, elopement, and unexpected death.

The investigation found that staff failed to provide sufficient care and supervision to resident R1, did not seek timely medical treatment after an unwitnessed fall, and were unclear about facility policies regarding emergency response. Additionally, multiple elopements were not reported to the licensing agency, and unsafe walkway conditions were observed. Immediate civil penalties were assessed for serious bodily injury and deficiencies related to supervision, administration, and reporting.

The investigation was triggered by a complaint regarding a resident's elopement and subsequent unexpected death. The complaint was substantiated with findings of insufficient care, failure to report incidents, and unsafe conditions.

The visit was a case management inspection conducted following a death notification received by the department regarding an unexpected resident death.

The inspection found no deficiencies. The resident's death appeared natural with multiple co-morbidities, and the coroner's report was pending.

The visit was a case management incident inspection conducted following a death notification received for a resident (R1) who passed away while hospitalized. The inspection involved review of records and interviews related to the incident.

No deficiencies were noted during the inspection. The Licensing Program Analyst reviewed resident records, conducted interviews with staff, and requested additional documentation related to the resident's care.

The inspection was a case management visit triggered by incident reports involving medication documentation irregularities and a resident missing from memory care.

The investigation found staff failed to follow medication policies resulting in a resident not receiving prescribed medication, and inadequate staffing to monitor a resident with exit-seeking behavior, posing immediate health and safety risks.

The visit was complaint-related due to incident reports received on 11/5/24 involving medication errors for resident R1 and a missing resident R2 from memory care. The complaint was substantiated with findings of staff noncompliance and inadequate staffing.

The inspection was conducted as a case management visit following receipt of an incident report regarding resident R1 leaving the facility unassisted on 2024-09-07.

The investigation found that R1, a memory care resident with mild cognitive impairment, exited the facility unassisted due to insufficient monitoring after front desk alarms were only monitored until 5 PM and staffing was limited. This posed an immediate health and safety risk to the resident.

The visit was complaint-related due to an incident report of R1 leaving the facility unassisted. The incident was substantiated as an immediate health and safety risk due to inadequate staffing and monitoring.

The visit was an unannounced case management visit to confirm orders for immediate exclusion of an individual from all facilities.

The facility was informed of an immediate exclusion effective 09/13/2024, prohibiting the excluded individual (S1) from working, living in, or having contact with clients in any residential facility licensed by the California Department of Social Services.

An unannounced complaint investigation visit was conducted in response to a complaint received on 2024-06-12 regarding concerns about the cleanliness and sanitation of a resident's bathroom.

The investigation found the allegation to be unsubstantiated as there was insufficient evidence to prove the alleged violation occurred. The resident interviewed expressed satisfaction with the cleaning assistance provided.

The complaint alleged that staff did not ensure that a resident's bathroom was clean and sanitary. The investigation included interviews and records review. The allegation was found unsubstantiated due to lack of preponderance of evidence.

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The visit was a case management follow-up conducted to review incident reports related to resident falls and an altercation between residents.

The Licensing Program Analyst observed that the residents involved had their care needs met, no further falls occurred, and no health, safety, or supervision issues were noted. No deficiencies were found during the inspection.

The visit was a case management incident investigation conducted due to a report received on 6/6/24 regarding an incident on 6/4/24 where a medication technician forced a resident (R1) to take medications against their will.

The investigation found that medication tech S1, assisted by caregivers S2 and S3, forcibly administered medications to resident R1 by restraining and covering the resident's mouth. S1's employment was terminated and S2 and S3 were suspended pending further action. Staff training on mandated reporting, resident rights, and restraint policy was reviewed and additional training planned. Two Type A deficiencies were cited related to forcing medication and failure to report suspected physical abuse within 24 hours, both posing immediate risk to residents.

The complaint involved a report submitted by the Director on 6/6/24 about an incident on 6/4/24 where medication tech S1 forced resident R1 to take medications by restraining and covering the resident's mouth. The incident was reported to the Memory Care Director and the facility Director. Employment and disciplinary actions were taken against involved staff. The complaint was substantiated with deficiencies cited.

The visit was a case management follow-up conducted by Licensing Program Analyst Kevin Mknelly to follow up on an incident involving resident R1 that occurred on 2024-05-02.

No deficiencies were noted as a result of the inspection. The analyst conducted six interviews with caregivers and med techs and requested additional records related to resident R1's hospice care and prior hospitalization.

The inspection was a case management visit conducted following an incident report received on 04/24/2024 regarding a resident (R1) who exited the memory care unit and left the property unassisted on 04/20/2024.

The investigation found that the facility's delayed egress alarms were functioning properly, but exit doors sometimes did not close completely. There were insufficient direct care staff on duty to support residents with dementia, posing an immediate risk to R1's health and safety.

The inspection was an unannounced Required-1 Year Inspection conducted to evaluate the health and safety conditions of the facility and ensure compliance with licensing requirements.

The inspection found the facility to be in compliance with no deficiencies cited. The environment was clean and safe, medications were properly stored and administered, and all required safety equipment was operable.

The visit was an unannounced Case Management - Incident inspection to obtain information regarding an incident involving a missing bubble pack of oxycodone reported on 02/13/2024.

The facility conducted an internal investigation, notified the police and the resident's primary care physician, and provided in-service training on narcotics handling. No deficiencies were cited at this time.

The visit was triggered by a complaint related to a missing bubble pack of 30 oxycodone tablets delivered on 02/07/2024 and signed off by night shift staff. The facility reported the incident to the police and conducted an internal investigation.

The inspection was an unannounced complaint investigation visit triggered by an allegation that unskilled staff were administering medication to residents, specifically concerning the administration of Morphine to a hospice resident.

The investigation included interviews with staff and review of relevant documentation. The allegation that unlicensed staff administered Morphine was found to be unsubstantiated based on statements from medication technicians, hospice nurse, and review of physician orders and medication administration policies.

The complaint alleged that staff who are not appropriately skilled professionals were administering medication, specifically Morphine, to residents. The investigation found no evidence to substantiate this claim, with multiple staff and hospice nurse statements confirming that only licensed nurses, hospice nurses, and trained family members administered Morphine.

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The visit was an unannounced Case Management - Incident inspection conducted to obtain information regarding an incident reported on 09/25/2023 involving a missing bubble pack of 30 Tramadol 50mg from the narcotic drawer on 09/10/2023.

The facility conducted an internal investigation, notified the police and relevant parties, and provided in-service training on narcotic count and medication room policies. No deficiencies were cited at the time of the visit.

The visit was triggered by a complaint/incident report regarding a missing narcotic medication. The incident was investigated internally and involved notification of the police and the resident's doctor. No deficiencies were cited.

Unannounced complaint investigation visit conducted in response to allegations received on 2023-05-10 regarding staff not providing timely incontinence care, not attending to a vomiting resident timely, not redirecting a wandering resident, and not answering the facility door for visitors.

The investigation included interviews with facility staff and review of relevant documentation. All allegations were found to be unsubstantiated due to lack of preponderance of evidence supporting the claims.

The complaint investigation was unsubstantiated. Allegations included staff not providing timely incontinence care, not attending to a vomiting resident timely, not redirecting a wandering resident, and not answering the facility door for visitors. Interviews and record reviews did not support these allegations.

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No findings or content related to facility inspection or regulation are present in the document.

The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 2023-05-05 alleging insufficient staffing to meet residents' needs and staff verbal abuse towards residents.

The investigation found the allegations to be unsubstantiated. Interviews with staff and residents indicated that residents' needs were being met and no verbal abuse was witnessed. Staffing levels were reviewed including a staffing ratio waiver and staff schedules, and response times to resident call pendants were generally reasonable.

The complaint alleged insufficient staffing to meet residents' needs and staff verbally abusing residents. The investigation included interviews with six staff and four residents, review of staffing schedules, call logs, and resident pendant response times. The evidence did not support the allegations, resulting in an unsubstantiated finding.

The inspection visit was an unannounced Case Management - Health Checks to ensure the health and safety of residents in care.

The facility was toured including common areas, kitchen, residents' bedrooms and bathrooms. No immediate health, safety, or personal rights violations were observed. The facility was found to be in substantial compliance with no deficiencies cited.

The visit was an unannounced Case Management - Incident inspection conducted to obtain information regarding an incident reported on 04/25/2023 involving alleged rude and cussing behavior by a staff member towards residents.

The investigation included review of incident reports, physician's reports, assessments, and interviews with staff. At the time of the visit, no deficiencies were cited, and the staff member involved was suspended pending further investigation.

The complaint involved a report by resident R1 that staff member S1 was cussing and speaking rudely towards residents R1 and R2. A written and signed statement from R1 was received. The staff member was suspended and an investigation is pending.

The inspection visit was an unannounced Case Management - Health Checks to ensure the health and safety of residents in care.

No immediate health, safety, or personal rights violations were observed during the tour of the facility. The facility was found to be in substantial compliance with no deficiencies cited as a result of the inspection.

The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 2022-10-04 alleging that staff did not adhere to a resident's admissions agreement.

The investigation found that the allegation was unfounded. The resident's needs were being met, staff conducted frequent status checks, and no deficiencies were cited during the visit.

The complaint alleged that facility staff did not ensure to call the resident and conduct status checks twice daily as per the admission agreement. The investigation reviewed medical and care records, interviewed four staff members and the resident, and reviewed call logs showing frequent checks and timely responses. The allegation was determined to be unfounded.

The inspection was an unannounced Required-1 Year Inspection focusing on the infection control domain to ensure health and safety compliance at the facility.

The facility was found to be in substantial compliance with no immediate health, safety, or personal rights violations observed. No deficiencies were cited as a result of the inspection.

The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 07/05/2022 regarding allegations that the facility did not refund as specified in the Admission Agreement and that the facility did not have adequate staffing to meet residents' needs.

The complaint that the facility did not refund the responsible party as specified in the Admission Agreement was substantiated, with evidence showing the facility initially failed to provide the refund but later issued a refund of $4625. The allegation regarding inadequate staffing to meet residents' needs was unsubstantiated based on interviews, staff schedules, and level of care assessments.

The complaint investigation was substantiated regarding failure to refund as specified in the Admission Agreement. The allegation about inadequate staffing was unsubstantiated due to lack of sufficient evidence.

The inspection was an unannounced complaint investigation visit triggered by a complaint received on 04/13/2022 regarding allegations of resident neglect including not being changed, strong urine odor in bedroom, lack of re-evaluation for change of condition, lack of medical attention, and over medication.

The complaint investigation substantiated that a resident was not kept clean and dry, resulting in a strong urine odor in the resident's bedroom, posing a potential health and safety risk. Other allegations regarding lack of re-evaluation for change of condition and lack of medical attention were found to be unfounded. The allegation of over medication was unsubstantiated due to lack of evidence.

The complaint investigation was substantiated for the allegation that a resident was not changed and the bedroom smelled of urine. The investigation found that staff did not consistently change the resident's incontinence briefs, resulting in strong urine odor. Other allegations including resident not re-evaluated for change of condition and resident did not receive medical attention were unfounded. The allegation that the resident was over medicated was unsubstantiated.

The visit was an unannounced Case Management - Health Checks inspection conducted to ensure the health and safety of residents in care.

The Licensing Program Analyst toured the facility and observed residents participating in activities. No immediate health, safety, or personal rights violations were found, and the facility was found to be in substantial compliance with no deficiencies cited.

The inspection visit was an unannounced Case Management - Health Checks to ensure the health and safety of residents in care.

No immediate health, safety, or personal rights violations were observed during the tour of the facility. The facility was found to be in substantial compliance with no deficiencies cited.

The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-02-02 regarding multiple allegations of inadequate care and supervision at Meadow Oaks of Roseville.

The investigation found all allegations unsubstantiated after interviews with staff, review of resident records, and facility observations. The facility was found to provide adequate hygiene assistance, incontinence care, food service, and maintenance, with no evidence of residents being left unattended or sustaining pressure sores due to neglect.

The complaint included allegations that staff did not assist residents with hygiene needs, failed to provide adequate incontinence care, left residents unattended, did not provide adequate food service, residents sustained pressure sores due to lack of care, and that the facility was in disrepair. All allegations were found unsubstantiated based on interviews, documentation review, and observations.

The inspection visit was an unannounced Case Management - Health Checks to ensure the health and safety of residents in care.

No immediate health, safety, or personal rights violations were observed during the tour of the facility. The facility was found to be in substantial compliance and no deficiencies were cited.

The inspection was an unannounced complaint investigation visit triggered by complaints received on 2021-10-13 regarding inadequate staffing, non-adherence to COVID protocols, and improper notice of resident rate increase.

The investigation found all allegations to be unsubstantiated or unfounded. Staffing levels were supported by agency staff and timecards, COVID protocol adherence was confirmed, and proper notice of rate increase was documented with signed agreements.

The complaint investigation addressed allegations that the facility did not have adequate staffing, staff were not adhering to COVID protocols, and the facility raised a resident's rate without proper notice. All allegations were found to be unsubstantiated or unfounded after review of interviews, documentation, and timecards.

The inspection was an unannounced Required-1 Year Inspection focusing on the infection control domain to ensure compliance with health and safety standards.

The facility was found to be in substantial compliance with no immediate health, safety, or personal rights violations observed. No deficiencies were cited as a result of the inspection.

Unannounced complaint investigation visit conducted in response to a complaint received on 12/18/2020 alleging resident physical abuse and failure to treat residents with dignity and respect.

The investigation substantiated allegations that a staff member physically abused a resident by twisting their wrist and verbally abused residents, failing to treat them with dignity and respect. Other allegations regarding hygiene assistance and food service were found unsubstantiated.

The complaint was substantiated regarding physical abuse of a resident by staff member S2 twisting R1's wrist and verbal abuse towards residents including calling a resident 'stupid and dumb'. Staff S2 was suspended and later resigned. Other allegations about hygiene assistance and food service were unsubstantiated.

The inspection was an unannounced complaint investigation visit conducted in response to an allegation that a resident obtained a pressure injury at the facility due to neglect.

The investigation found no documentation or evidence supporting the allegation of neglect causing a pressure injury. Staff interviews and medical records indicated the resident had a history of skin fragility but no pressure injuries were observed or documented. The allegation was determined to be unsubstantiated.

The complaint alleged that a resident obtained a pressure injury at the facility due to neglect. The investigation was unsubstantiated based on records review, staff interviews, and medical documentation.

The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 2020-10-26 alleging lack of supervision resulting in resident wandering away from the facility and failure to notify resident's authorized representative of change in health condition and failure to seek timely medical attention for resident.

The investigation substantiated the allegation that lack of supervision resulted in a resident wandering away from the facility, posing an immediate threat to the resident's health and safety. Another allegation regarding failure to notify the resident's authorized representative and failure to seek timely medical attention was found to be unsubstantiated.

The complaint investigation was triggered by allegations that a resident (R1) was able to leave the facility without staff knowledge due to lack of supervision, and that staff failed to notify the resident's authorized representative of a change in health condition and did not seek timely medical attention. The allegation of lack of supervision was substantiated, while the allegations regarding notification and medical attention were unsubstantiated.

The inspection was an unannounced Required-1 Year Inspection focusing on the infection control domain to ensure health and safety compliance at the facility.

The facility was found to be in substantial compliance with no immediate health, safety, or personal rights violations observed during the inspection. No deficiencies were cited as a result of the inspection.

Unannounced complaint investigation visit conducted due to an allegation that staff did not ensure a resident's colostomy bag was changed.

The allegation was found to be unsubstantiated after review of resident records, interviews with the resident's spouse and facility staff, and consideration of the resident's ability to self-manage the colostomy bag. No evidence supported the claim that staff failed to assist the resident.

The complaint alleged that resident R1 was not receiving assistance with their colostomy bag. Investigations included review of medical and care assessments indicating R1 could self-manage, interviews with R1's spouse and staff confirming R1's ability and need for reminders, and the fact that R1 had passed away prior to the investigation. The allegation was unsubstantiated.

The visit was an unannounced complaint investigation conducted in response to a complaint received on 2020-10-19 alleging that staff did not assist a resident with hygiene needs and would not allow a resident to have a visitor.

The investigation found that the resident was able to self-manage grooming and colostomy care with some assistance and reminders, and that visitor guidelines were in compliance with state regulations. Due to lack of sufficient evidence, the allegations were found to be unsubstantiated.

The complaint alleged that staff did not assist resident R1 with hygiene needs and did not allow R1 to have visitors. The investigation included record reviews, staff and family interviews, and observation of visitor guidelines. The allegations were determined to be unsubstantiated due to insufficient evidence.

The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2020-09-24 alleging facility disrepair and staff misconduct including not safeguarding resident's personal belongings, causing injury to a resident, and turning off call buttons.

The investigation found all allegations to be unsubstantiated. The facility was observed to be in good repair, and interviews and document reviews did not support the allegations. Recommendations were made to improve documentation such as creating a supply log for residents' personal belongings.

The complaint was investigated and found to be unsubstantiated. Allegations included staff not safeguarding resident's personal belongings, staff causing injury to a resident, and staff turning off call buttons. Interviews with staff and review of relevant documents including incident reports and call pendant logs were conducted. No preponderance of evidence was found to prove the alleged violations occurred.

Licensing Program Analysts arrived unannounced to conduct a case management visit related to an ongoing investigation involving an alleged perpetrator held by the facility.

The facility is currently holding out the alleged perpetrator while performing an investigation. Licensing Program Analysts are awaiting more facts and determined that the case needs further investigation.

The inspection was conducted as an unannounced complaint investigation following a complaint received on 2020-12-17 regarding facility conditions.

The complaint was substantiated due to non-working light bulbs in the Memory Care unit bathroom and hallway, posing a potential health and safety risk to residents. The facility agreed to correct the deficiency by replacing the light bulbs.

The complaint alleged that the facility was in despair, specifically noting that light bulbs were not working in one of the bathrooms in the Memory Care unit, making it difficult for staff and residents to see. The complaint was substantiated after investigation.

An unannounced complaint investigation was conducted following a complaint received on 08/12/2020 regarding medication administration and communication issues at the facility.

The investigation substantiated that staff did not administer a resident's medication per physician's orders on multiple dates and failed to inform the authorized representative to renew the physician's order. Another allegation regarding inadequate food service was found to be unsubstantiated.

The complaint investigation was substantiated for allegations that staff did not administer medication per physician's order and failed to inform the authorized representative to renew the physician's order. The allegation that staff did not provide adequate food service was unsubstantiated.

The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2020-02-10 regarding a malodorous resident room.

The Licensing Program Analyst determined that a resident's room was malodorous and that basic services, including house cleaning, were not provided as required, posing a potential health and safety risk. The allegation was substantiated based on observations and evidence.

The complaint was substantiated. The allegation was that a resident's room was malodorous. The investigation found that basic services were not provided as required, and the allegation was substantiated based on the preponderance of evidence standard.

The inspection was an unannounced complaint investigation conducted in response to a complaint received on 07/16/2020 regarding personal rights concerns related to COVID-19 exposure and staff working conditions.

The investigation found that staff member S1 was instructed to work despite concerns of COVID-19 exposure, but after testing positive, the facility took appropriate action by not scheduling S1 to return to work for several days. The complaint was determined to be unsubstantiated due to insufficient evidence of a violation.

The complaint alleged that staff member S1 was required to work a full shift despite expressing concerns about being COVID-19 positive and symptoms. The investigation found that S1 was exposed to COVID-19, tested positive on 7/3/2020, and the facility acted by removing S1 from work for several days. The allegation was unsubstantiated.

The inspection was an unannounced complaint investigation visit triggered by complaints received on 2020-04-10 regarding allegations that the facility raised fees without giving proper notice to the responsible party, charged residents for services not provided, and did not do a reappraisal prior to raising care level fees.

The investigation substantiated that the facility raised fees without giving proper notice to the responsible party, citing a deficiency for failure to provide written notice of rate increase within two business days after initially providing services at the new level of care. The allegation that the facility charged residents for services not provided was unsubstantiated, as services billed were refunded. The allegation that the facility did not do a reappraisal prior to raising care level fees was unfounded, as a reappraisal was completed prior to raising fees.

The complaint investigation was based on three allegations: 1) Facility raised fees without giving proper notice to responsible party (substantiated), 2) Facility charged resident for services not provided (unsubstantiated), and 3) Facility did not do a reappraisal prior to raising care level fees (unfounded).