Failure to Provide Bed-Hold Notice and Permit Return After Hospitalization
Penalty
Summary
The facility failed to implement and document required procedures regarding bed-hold policies and resident rights for a Medicaid-covered resident who was transferred to the hospital for behavioral concerns, including physical aggression toward staff. There was no evidence that the resident or their representative received a written notice of the facility's bed-hold or readmission policy at the time of transfer, nor any documentation indicating acceptance or declination of a bed hold. Despite the facility's policy allowing a 15-day bed hold for Medicaid residents, the clinical record lacked any indication that the resident was informed of their rights to return or that the facility planned for the resident's readmission. Following the resident's transfer, social service notes documented attempts to place the resident in other facilities, all of which declined. Hospital staff repeatedly requested the resident's readmission, but the facility's corporate admissions representative imposed conditions for return that were not part of the documented policy. There was no evidence of a clinical reassessment or evaluation of the facility's ability to meet the resident's needs, nor any transfer or discharge planning documents. The Nursing Home Administrator and Director of Nursing confirmed the decision not to readmit the resident due to safety concerns, but there was no formal documentation of a review of the facility's capacity to care for the resident upon potential return.