Failure to Provide Written Bed-Hold Policy Notice to Resident's Guardian
Penalty
Summary
The facility failed to provide written notice of its bed-hold policy to the representative of a resident who was transferred to the hospital on multiple occasions. The resident in question was severely cognitively impaired, diagnosed with dementia, and had been legally declared incapacitated, with a court-appointed guardian responsible for medical and financial decisions. Although the facility's admission agreement included information about the bed-hold policy, there was no documented evidence that the guardian had reviewed or signed the agreement, nor that a copy of the policy was provided to the guardian upon admission. Additionally, the facility's policy stated that Medicaid would pay for a bed hold during hospitalization or therapeutic leave, but there was no documentation that this information was communicated in writing to the guardian at the time of any of the resident's hospital transfers. Interviews with facility staff revealed that the business office manager (BOM) was responsible for issuing bed-hold information, but the facility had not had a BOM for an extended period and could not provide employment dates for the previous BOM. The Nursing Home Administrator confirmed that no written notice of the bed-hold policy was issued to the resident's representative during the relevant hospital transfers. The lack of written notification meant the resident's guardian was not informed of the specifics of the bed-hold policy, including the duration, payment terms, or the right to return, as required by regulation.