Failure to Notify Responsible Parties and Ombudsman of Hospital Transfers
Penalty
Summary
The facility failed to provide timely written notification to the resident, responsible party, and Ombudsman regarding the reason for hospitalization for two residents. According to the facility's Transfer/Discharge Notification policy, before a resident is transferred or discharged, the facility must notify the resident and their representative in writing and send a copy to the Ombudsman. However, this procedure was not followed for two residents who were transferred to the hospital. Resident 68, who was cognitively intact and required assistance for daily care, was transferred to the hospital after experiencing difficulty breathing. Despite the transfer, there was no documented evidence of written notification to the resident's responsible party and the Ombudsman. Similarly, Resident 70, who was cognitively impaired and dependent on staff, was transferred to the hospital following a fall that resulted in a head laceration. Again, there was no documented evidence of written notification to the responsible party and the Ombudsman. The Nursing Home Administrator confirmed the lack of written notices for both residents.
Plan Of Correction
1. The facility cannot retroactively perform notifications for residents Transferred/Discharged. 2. Will review the past 2 weeks of hospital discharges for notification. 3. The Director Of Nursing/Designee will educate Licensed staff on- Transfer/Discharge Notification and Right to Appeal and document education. 4. Audits of notifications and documentation to be completed on residents Transferred/Discharged to the hospital 5x per week x2 weeks, Weekly x4 and Monthly x1. Findings will be monitored by the Executive Director and reported to Quality Assurance Performance Committee for additional oversight.