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F0628
D

Failure to Obtain Signed Bed Hold Notice During Resident Transfer

Sioux Center, Iowa Survey Completed on 06-26-2025

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 ensure that the required bed hold notice was properly signed by either the resident or the resident's responsible person when a resident was transferred out of the facility. Clinical record review showed that a resident with severe cognitive impairment, as indicated by a BIMS score of 01 and diagnoses including hypertension, anemia, and hyponatremia, was transferred to a hospital due to high potassium levels. Documentation revealed that while verbal consent for the bed hold was obtained from the resident's representative, the bed hold notice lacked both the required signature and the amount per day that the resident or representative agreed to pay. Facility policy requires written and verbal notice at admission and at the time of transfer, but this was not followed in this instance.

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