Resident 79 at Pasadena Palace TCU had been overcharged for coinsurance payments during her stay from April to June 2025. The billing records showed she paid $8,170.50 more than required out of her own pocket.
The facility's Business Office Coordinator first learned about the needed refund in the first or second week of August 2025. She sent an email to the facility's previous billing company on August 13, informing them that Resident 79 was requesting her money back.
Nothing happened for nearly two months.
On October 9, Business Office Manager 1 spoke with Resident 79's family member about the refund. The next day, Business Office Manager 2 sent another email to the previous biller on behalf of the family.
Then the facility stopped communicating about the money entirely.
When federal inspectors arrived on November 19, 2025, Resident 79 still had not received her $8,170.50. The Business Office Coordinator told inspectors she had not heard anything about the refund since the October 10 email until inspectors informed her that day that the resident was still waiting for her money.
The Business Office Coordinator acknowledged that another follow-up should have been made after the October 10 email to ensure Resident 79 received her reimbursement. She told inspectors that following up is important "to make sure the process is being followed and that the residents are getting their requested refunds."
Business Office Manager 1 admitted there was no follow up with Resident 79's family after October 10. She said she had assumed the refund was taken care of.
The facility's own billing coordinator explained the normal admission process involves checking and verifying a resident's insurance, then speaking with either the resident or family representative to explain benefits, what insurance covers, and whether there are any copayments or share of costs.
But when it came time to return money the facility had collected in error, that same attention to process disappeared.
The $8,170.50 represented coinsurance payments that Resident 79 had made out of pocket. Coinsurance is the percentage of costs for covered healthcare services that patients pay after meeting their insurance deductible. In this case, the resident had paid far more than her insurance required.
Email records reviewed by inspectors showed the extent of the facility's communication efforts: one message on August 13 from the Business Office Coordinator, and one message on October 10 from Business Office Manager 2. Both emails went to the facility's previous billing company, asking them to handle the refund.
The previous biller had told the Business Office Coordinator that she would reach out to Resident 79's family. But there was no evidence that staff verified this contact occurred or confirmed the family received any communication about their money.
For over a month after the October 10 email, nobody at Pasadena Palace TCU checked on the status of the refund. The facility's own business office staff, who had explained the importance of following up to ensure residents get their requested refunds, made no additional effort to recover the resident's $8,170.50.
The inspection occurred as part of a complaint investigation. Federal inspectors found the facility had failed to properly manage resident funds, citing minimal harm with the potential for actual harm affecting few residents.
When inspectors interviewed the Business Office Coordinator on November 19 at 3:17 PM, she reviewed the email thread between herself, Business Office Manager 2, and the previous biller. The records showed no communication about Resident 79's refund had occurred since October 10, 2025.
The resident's billing records, covering her stay from April 3, 2025 to June 14, 2025, clearly documented the $8,170.50 overpayment. Yet three months after the facility first learned about the error, and more than a month after promising the family action would be taken, Resident 79 was still waiting for her money.
Business Office Manager 1's assumption that the refund had been "taken care of" proved incorrect, leaving the resident without funds that belonged to her while facility staff moved on to other matters.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Pasadena Palace Tcu from 2025-11-19 including all violations, facility responses, and corrective action plans.