Aegis Senior Inns

Complaint: [redacted] I am rejecting this response because: it is inaccurate Prior to explaining the inaccuracies, I would like to take exception to the term "quality care" There were multiple concerns with the care over the time period that Dad was a resident of Aegis including: An Aegis employee stealing my Dad's Masonic diamond ring that Dad had worn 24/for years Dad walking out of the "secure" facility and the staff not knowing that Dad was missing until an employee from the office park across the street returned him Dad exiting the facility and walking to a busy intersection several blocks away where a good Samaritan helped him into her car Once again Aegis did not know he was missing until I contacted them after the Kent Police called me Dad being hospitalized for a six inch pressure ulcer (aka bed sore) that Aegis staff did not notice That said, we stayed at Aegis even with the above issues as we did not want to put Dad through the experience of changing residences and there were certainly a lot of loving, caring staff that provided care for Dad with compassion and concern With regard to this complaint, the most recent response is the first we knew that charges were based on a negotiations process We thought they were based on the assessment We still want the following: New clients and their families to receive a copy of the scoring rubric that accompanies the assessment It will help the families to determine the services they wish to have (i.efrequency of showering; laundry, etc.) 2, Clients and their families to be apprised when the assessment tool changes Forty items were added after Dad became a resident I have documentation of this A refund for the charges incurred by the items that were added to the assessment tool when it was changed after Dad's admission to Aegis And one additional item given the most recent response: For clients and their families to be apprised that the cost of care is a negotiation Sincerely, [redacted] ***

Thank you for forwarding Mr. [redacted]'s concerns to our office regarding our Assessment Tool.[redacted] was a resident with Aegis of Kent from June 8, 2011 until his daughter chose to move [redacted] out dueto higher care requirements affective March 30, 2016.For every resident that resides in an Aegis community,...

we perform assessments and reassessments ofthe care they need at least quarterly, or more frequently as needed due to a change in condition. It is avery typical progression for our residents to have their care needs increase as they age and require moreassistance with the activities of daily living.[redacted]'s stay with us was typical in this respect. During [redacted]'s stay, he underwent quarterly assessmentswhich were consistently shared with Mrs. [redacted], offering her the opportunity to discuss the care planthat was currently in place and the costs associated with each new care pl an. Some quarters his careneeds, and associated costs, increased; other quarters, [redacted]'s care plan remained the same. However,as his health declined dramatically and his dementia worsened, the care plan was changed to reflect hischanging needs.
Specifically, over the course of [redacted]'s stay, Aegis completed approximately 26 new assessments of hiscare needs. Each time, we notified Mrs. [redacted] when there were any changes, and she had theopportunity every time to provide us 30 days' notice and move her father out if she had concerns aboutthe cost, the care, or anything else related to his home with us at Aegis. Not once during this four yearperiod did Mrs. [redacted] ever object to the care that was provided to her father, nor did she ever questionthe validity of the care plan as they were assessed.The objection Mrs. [redacted] did have, however, was the price charged for the care provided. In responseto this objection, Aegis agreed for a period to lower the cost. When, about a year ago, Aegissubsequently raised the cost by $0.02 per point assessed for the care provided, Mrs. [redacted] agreed.
On a company-wide basis, Aegis revamped it's assessment tool last year to assure that it was capturingour resident's care needs. Upon her father's latest assessment in February of this year, Mrs. [redacted]raised a concern about the changes in her father's care plan reflected by the assessment tool. We metand discussed the changes to the care plan. We discussed the fact that since his residency began, thecare plan changed to reflect his needs -again, some items were added, and some items were removed.At the end of the day, however, his care plan needed to change to reflect his increased needs.Mrs. [redacted] was always made aware of the need for assessments, and that the care for her father wouldchange over time. She always had the right to move her father out upon just 30 days' notice if shedisagreed, but chose not to do so. We respect her decision to move her father out at this point;however, we will not agree to provide her a refund now for the care that we provided for 5 years.Should you require further information, please feel free to ca ll or email at your earliest convenience.Sincerely,Laurel C[redacted]please see attached[redacted]

Complaint: [redacted]I am rejecting this response because:
It seems as though there was a lack of communication/understanding of my concern.  I will summarize the concerns again in bullet from which will hopefully help with clarity:
1.  The assessment tool changed from initial entry to Aegis without us being apprised of the changes and it was immediately implemented.  (The new tool had approximately 40 additional items to score and to charge fees upon)
2. The scoring rubric for the assessment tool was not shared until the last month of my Dad's four year nine month residency
3.  It was shared that the items in the assessment tool are required by WAC,  We could not see any one-to-one correspondence between the tool and WAC.  Additionally assessment tools vary from facility to facility so suggesting that the WAC requires each individual assessment item is not accurate)
4. The cost of care included the items added to the assessment after entry,
Our requested remediation was:
1.  Apprise families/guardians when there is a change in the assessment tool prior to implementation.
2.  Share the scoring rubric with each family/guardian when their loved one enrolls to be a resident.
3.  Do not use the WAC as the reason for additional items on the assessment unless it really is.  Rather say that WAC requires an assessment.
4.  Provide remuneration for charges incurred for charges incurred by the addition of additional assessment items added to the initial assessment tool,  This is not five years of care rather a portion of the care fee for the period of time since the implementation of the new assessment tool.
Sincerely,[redacted]

Complaint: [redacted]I am rejecting this response because: it is inaccurate.  Prior to explaining the inaccuracies, I would like to take exception to the term "quality care".  There were multiple concerns with the care over the time period that Dad was a resident of Aegis including:
           1. An Aegis employee stealing my Dad's Masonic diamond ring that Dad had worn 24/7 for 53 years
           2.  Dad walking out of the "secure" facility and the staff not knowing that Dad was missing until an employee from the office park across the street returned him
           3.  Dad exiting the facility and walking to a busy intersection several blocks away where a good Samaritan helped him into her car.  Once again Aegis did not know he was missing until I contacted them after the Kent Police called me.
           4.  Dad being hospitalized for a six inch pressure ulcer (aka bed sore) that Aegis staff did not notice 
That said, we stayed at Aegis even with the above issues as we did not want to put Dad through the experience of changing residences and there were certainly a  lot of loving, caring staff that provided care for Dad with compassion and concern.
With regard to this complaint, the most recent response is the first we knew that charges were based on a negotiations process.  We thought they were based on the assessment.  We still want the following:
           1.  New clients and their families to receive a copy of the scoring rubric that accompanies the assessment.  It will help the families to determine the services they wish to have (i.e. frequency of showering; laundry, etc.)
            2,  Clients and their families to be apprised when the assessment tool changes.  Forty items were added after Dad became a resident.  I have documentation of this.
            3.  A refund for the charges incurred by the items that were added to the assessment tool when it was changed after Dad's admission to Aegis.
        And one additional item given the most recent response:
            4.  For clients and their families to be apprised that the cost of care is a negotiation.
Sincerely,[redacted]

Revdex.com
Attn: [redacted]
PO Box 1000
DuPont, WA 98327
Re:  [redacted] Complaint – Response to Request for Clarification
Dear [redacted]:
Thank you for providing us notice of the renewed request for refund from Mrs. [redacted] (“the consumer”).
As discussed in our previous response dated April 13, Aegis of Kent regularly assesses the care needs of each of our assisted living residents. In this case, the resident (the consumer’s father) was assessed approximately 26 different times over the course of his stay with us. Each time, the results of the assessment were used to update the resident’s individualized care plan, and to determine the appropriate monthly charges based on Aegis’s proprietary points system. Each time, the consumer as her father’s representative reviewed the care plan and proposed monthly charges, and had an opportunity to negotiate changes to either the plan or the cost. Each and every time, the consumer ultimately approved the care plan and accepted the monthly charges.
Aegis updated its proprietary back-end procedures a number of times over the years that the consumer’s father was a resident with us. To the extent that those updates resulted in changes to the way charges were calculated, the changes were clearly communicated to the consumer at the time they took effect. Throughout her father’s stay, the consumer was given clear communications about the services that Aegis would be providing and the cost of those services. Aegis provided all of the services it agreed to provide. We respectfully disagree that any portion of the resulting charges, or the basis for those charges, was ever hidden from the resident or his family.
We believe our previous response fully addresses each of the consumer’s concerns. However, for clarity we address each of her points below.
The consumer was apprised of changes to Aegis’s assessment tool in December 2012, and again in 2015. But in any event, the relevant issue is whether the consumer had full and fair notice of the services being provided and the charge for those services. She did, signing off on each of the 26 care plans and the associated notices of charges.
Additionally, the consumer references “40 additional items” she believes were added to the new tool compared to the old tool. That is incorrect, and appears to be confusion stemming from the difference between a printout of the entire new assessment tool as compared to a printout of the abbreviated results summary for the older assessment. Both Aegis’s current assessment tool, and the one in use at the time the consumer’s father first entered Aegis, examine similar types and numbers of care need indicators.
The consumer was at all times aware of the services being provided through her father’s care plan and the charges for those services. The proprietary assessment tool used to develop the care plan, and the scoring rubric used to fairly and consistently determine pricing across residents with very different care needs, are not relevant to whether the consumer was given full and fair notice of charges throughout her father’s stay.
As a licensed assisted living provider, Aegis is required by Washington law to conduct full assessments of each of its residents to determine care needs. The assessment must include many categories of need indicators including recent medical history, current and contraindicated medications and treatments, nursing needs, sensory and communication abilities, behavioral issues, special needs, personal care needs for assistance with both activities of daily living and instrumental activities of daily living, activity and service preferences, individual identiy and lifestyle preferences, and substitute decision-making. Each of those categories in turn has numerous sub-assessments. While different facilities measure those need indicators differently, Aegis believes that its assessment tool is an accurate, fair method of capturing all of the many considerations that go into creating a safe care plan for our residents.
Again, the cost of care was at all times disclosed and signed off by the consumer prior to incurring any charges. At all times, the charges were based on the services described in details in the resident’s care plan. The assessment used to generate the care plan, and the points system used to calculate a fair price for providing the care plan services, are proprietary business practices that were not relevant to the question of whether the consumer was given full and fair notice of Aegis’s charges.
Aegis provided the consumer’s father with quality care for several years, based on an individualized care plan that was reviewed and signed by the consumer, at a monthly cost that was negotiated and agreed up front.  Aegis fully provided all of the agreed services.  Accordingly, Aegis respectfully disagrees that any refund of the agreed charges is appropriate.
Should you require any additional information, please do not hesitate to call or email.
Sincerely,
Laurel C[redacted]
General Manager
[redacted]
[redacted]