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F0623
B

Failure to Provide Written Notice of Hospital Transfer

Waymart, Pennsylvania Survey Completed on 02-14-2025

Penalty

Fine: $19,775
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide a written notice of a facility-initiated hospital transfer to a resident and their representative, which is a requirement under §483.15(c)(3)-(6)(8). This deficiency was identified during a review of clinical records and facility-initiated transfer notices, as well as through staff interviews. Specifically, the deficiency involved Resident 46, who was admitted to the facility with diagnoses including atrial fibrillation, heart disease, and a fracture of the left radius and ulna styloid process. The resident was transferred to the hospital on January 6, 2025, and readmitted to the facility on January 12, 2025. Upon reviewing the clinical record, it was found that there was no documented evidence that the facility provided the resident and their responsible party with a written notice of the transfer and the reason for it. This was confirmed in an interview with the Administrator, who acknowledged the lack of documentation indicating that the resident's responsible party was informed in writing about the transfer. This failure to provide the required notice constitutes a violation of the regulatory requirements for transfer and discharge notifications.

Plan Of Correction

Preparation and/or execution of this plan of correction in general, or this corrective action does not constitute an admission of agreement by this facility of the facts alleged or conclusion set forth in this statement of deficiencies. The plan of correction and specific corrective actions are prepared and/or executed in compliance with State and Federal laws. Deficient practice cannot be corrected as the missing transfer form cannot be located or replaced. Re-educate the nursing staff on completion of the Transfer/Discharge Form. The Business Office Manager/designee will create a spreadsheet to monitor the receipt of all Transfer/Discharge Forms compared to the Daily Census. The Business Office Manager/designee will report results of the audit to QAPI monthly x 3 months.

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