Failure to Provide Bed-Hold Policy Notification and Complete Transfer Documentation
Penalty
Summary
The facility failed to provide required written notice of its bed-hold policy, including the duration a bed can be held during a leave of absence and the associated cost per day, to residents and/or their representatives at the time of transfer. This deficiency was identified through review of facility policies, clinical records, and staff interviews, which revealed that three residents were transferred to the hospital without documentation that the bed-hold policy was communicated to them or their representatives. Additionally, the clinical records for these residents did not contain evidence that necessary clinical information was communicated to the receiving health care provider upon transfer. Specifically, one resident with chronic obstructive pulmonary disease, Parkinson’s disease, and hypertension was transferred to the hospital without documentation of the required notifications or communication of clinical information. Another resident with atrial fibrillation, heart failure, anxiety disorder, and hypertension experienced multiple hospital transfers, with records lacking both the bed-hold policy notification and complete documentation regarding the basis for transfer, interventions, and appropriate contacts. A third resident with heart disease, atrial fibrillation, heart failure, hypertension, and anxiety was also transferred without evidence of bed-hold policy notification. The DON confirmed these deficiencies during an interview.