Obtaining a Refund from a Residential Care Facility
Families entrust that a Residential Care/Assisted Living facility will offer sufficient care and services when a loved one moves in. Sadly, plans don't always work out and residents might have to check out of the facility. Obtaining a refund from Residential Care Facilities for the Elderly (RFCE), or Assisted Living Facilities is not always easy. This might lead to annoyance and misunderstanding when requesting reimbursements. A lot of this can be avoided by reading the guidelines and conditions provided for a refund.
Admission Agreements for Assisted living facilities are legal contracts that state the responsibilities of both the facility and the resident. It is something that needs to be read carefully before signing.
Basic Pre-Admission Fee Refund Requirements
Pre-admission fees must be refunded FULL (100%) if the resident did not enter the facility, and no assessment was done, or the facility failed to disclose the pre-admission fee charges and refund conditions.
During the first three months, proportional refunds of pre-admission fees in excess of $500 are also required. This is as follows:
80% if the person does not enter the facility but a pre-admission appraisal was done
80% if a resident leaves the facility during the first month for any reason
60% if a resident leaves the facility during the second month for any reason
40% if a resident leaves the facility during the third month for any reason
Remember that pre-admission fees are not a requirement so it is better to find facilities without them. You should also always try to negotiate the amount for it to work for you. The facility is responsible for doing assessments, so don't pay anyone else privately to do it. Instead, pay the facility directly to ensure that you can get a refund if needed.
Refund requirements for discharged patients or patients who decide to leave
Eviction notices are required to be given 30-days before and are only allowed for specific and valid reasons. A proportional refund can be requested if the resident moved out prior to the 30 days. There are laws that protect the rights of residents for eviction.
Currently there are only 5 recognized reasons for evictions:
Failure of resident to pay
Failure of resident to comply with state or local laws
Failure of resident to follow facility policies
When the facility cannot meet the resident’s care needs
The facility will not operate anymore as a Residential Care Facility for the Elderly.
Standard practice requires the resident to give a 30-day written notice before leaving the facility, so avoid agreements that require a 60-day notice. Also take note of the history of poor and inadequate care that caused damage to the health of the resident and argue for a full refund. A 3-day notice may also be granted if the resident is starting to demonstrate behavior that puts themselves or other residents in danger physically or mentally.
Refund After the Death of a Resident
Charges are prohibited once all of the personal properties of the deceased resident are moved out of the facility. If the contract says they can charge fees after death while the person's belongings are still there, the facility must give the person responsible for the resident a written notice explaining their policies for ending the contract after death and giving refunds. They must also give this notice within three days of finding out that the resident has passed away.
If the facility has taken any fees in advance for the time after the belongings have been removed, they are required by law to refund that money within 15 days of the belongings being taken away. The refund should go to the person or organization responsible for paying the fees, or to the deceased resident's estate if they paid the fees. Always remember to check the agreement to see the conditions regarding the charges and refunds after the death of the resident. Try to also remove the properties as soon as possible.
Complaints
Do not be afraid to advocate for your rights to obtain a refund. Every person has the right to complain to the Community Care Licensing (CCL) which is the agency that is responsible for complaints. You are protected by law and have a right to call out abuse, neglect, eviction issues, and other mistreatment. The investigation may take 10 working days or more depending on the case.
You may send your complaints to the Centralized Complain & Information Bureau (CCIB)
Contact information of CCIB:
Fax: (916) 651-6668
Email: letusno@dds.ca.gov
You may also contact elected state officials in California. You can check out the California Legislature website in order to find out your district representative and how to contact them.
Conclusion
Obtaining a refund from a Residential Care Facility for the Elderly (RCFE) can be difficult for people but that can be reduced by knowing the terms of agreements and knowing your rights. By knowing the procedures and regulatory laws, obtaining a refund wouldn’t be such a tedious task. Mistreatment and inadequate care are subjects to complaints that should be voiced out properly and in an orderly manner.
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