Failure to Provide Written Notice and Reason for Resident Room Changes
Penalty
Summary
Facility staff failed to provide a resident with written notice and the reason for multiple room changes, as required by resident rights regulations. Clinical record review showed that the resident was moved between rooms on several occasions, but there was no documentation of written notification or the reasons for these changes in the nursing progress notes. While there was a note indicating verbal notification and consent for one room change, there was no evidence that written notice was provided for any of the moves. Additionally, staff interviews revealed that nurse managers and the admissions director could not explain the reason for at least one of the room changes, and the social worker confirmed that no written notification was given. The facility's policy on room transfers requires notification and documentation, but the records reviewed did not show compliance with these procedures. The resident was on a leave of absence during the survey and could not be interviewed. The clinical notes indicated that the resident was alert, verbally responsive, and had stable skin condition at the time of the moves. However, the lack of written notice and documentation of reasons for the room changes constituted a failure to honor the resident's rights.