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F0628
E

Failure to Provide Bed Hold and Transfer Notices During Hospitalizations

Pontiac, Illinois Survey Completed on 06-04-2025

Penalty

No penalty information released
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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 required written notifications to residents and their representatives regarding hospital transfers and bed hold policies for five residents who were hospitalized. Nursing notes documented multiple instances where residents were transferred to the emergency room or hospitalized, but there was no documentation in the medical records that a bed hold notice or written notice of transfer was provided to the residents or their representatives at the time of each transfer. The facility's own Bed Reserve Policy states that this information should be given at admission and each time a resident is transferred from the facility, but records and interviews confirmed this was not done. Interviews with facility staff, including the Social Service Director and an LPN, revealed that while the bed reserve policy is signed at admission, nursing staff do not provide the bed hold policy form when residents are transferred out. Instead, follow-up is reportedly handled by admissions or social services, but there was no evidence that this occurred for the residents in question. One resident confirmed not receiving any bed hold policy or paperwork during multiple hospitalizations. The lack of documentation and direct statements from staff and residents indicate that the facility did not meet regulatory requirements for notification during resident transfers.

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