Failure to Provide Required Written Discharge, Transfer, and Bed Hold Notifications
Penalty
Summary
The facility failed to provide required written discharge or transfer notifications and documentation to residents and their representatives for three residents who were either discharged or transferred to the hospital. For one resident who was discharged home, there was no written discharge notice, discharge summary, recapitulation of stay, or medication reconciliation documented in the medical record. Although the resident and family were verbally educated about medications and upcoming appointments, the necessary written documentation and notifications were not completed, and the Ombudsman did not receive a discharge notice. For two other residents who were transferred to the hospital after falls, the facility did not provide written transfer notifications or bed hold notifications as required. Staff interviews confirmed that written notices were not being completed or sent to the Ombudsman, and the Business Office Manager did not complete a bed hold notification for one of the residents. The Director of Nursing confirmed that these required notifications and summaries were not being documented or provided.