Failure to Communicate Required Resident Information During Transfers
Penalty
Summary
The facility failed to ensure that necessary resident information was communicated to the receiving health care provider during facility-initiated transfers for two of three sampled residents. For both residents, the clinical records showed that they were transferred to the hospital and later returned to the facility. However, there was no documented evidence that the facility provided the receiving health care provider with essential information, including the residents' care plan goals, advanced directive information, specific instructions for ongoing care, resident representative information, and all information necessary to meet the residents' specific needs at the receiving facility. One resident had diagnoses of high blood pressure, hyperlipidemia, and required assistance with personal care, while the other had high blood pressure, hyperlipidemia, and muscle weakness. Despite these medical needs, the required communication and documentation were not present in the clinical records for either transfer. The Director of Nursing confirmed during an interview that the necessary information was not communicated for these residents.