Failure to Inform Resident of Transportation Charges at Admission
Penalty
Summary
The facility failed to inform a resident of transportation costs as required in the admission agreement. The resident, who was admitted with multiple fractures and was under a Medicare-covered stay, was billed for transportation services on several occasions. However, neither the resident nor the family member was aware of these charges, and the family member stated they would not have used the facility's transportation if they had known about the cost. A review of the facility's policies and admission documents showed that transportation was listed as an extra charge, and residents or their representatives were supposed to be informed of such charges through the admission agreement and accompanying handbook. Despite this, the facility was unable to locate a signed admission agreement for the resident in question, either in the electronic medical record or the paper chart. Staff interviews revealed uncertainty about the timeframe for completing admission agreements and acknowledged that the process was behind schedule. The Social Services Designee, responsible for completing admission agreements, believed the agreement should have been completed and signed by the resident, but could not account for its absence. The Assistant Director of Nursing recalled discussing transportation fees with the resident but did not document the conversation, and there was no signed acknowledgment that the resident or representative had been educated about the transportation fee. As a result, the resident incurred charges for services without documented prior notification or consent.