Failure to Provide Required Transfer Documentation and Notifications
Penalty
Summary
Surveyors identified multiple deficiencies related to the facility's failure to provide required documentation and notifications during resident transfers and discharges. Specifically, staff did not document that reports were given to receiving hospitals regarding residents' conditions at the time of transfer, and e-interact forms were not completed for several residents transferred to acute care hospitals. Additionally, there was no evidence that written notifications of discharge were provided to residents or their representatives as required by facility policy and regulatory standards. The review also found that the facility did not notify the Office of the State Long Term Care Ombudsman (LTCO) when residents were transferred to hospitals or discharged to the community. Staff interviews revealed confusion regarding departmental responsibilities for LTCO notification, with both nursing and social services staff indicating the other was responsible. In several cases, staff were unable to provide documentation that notifications or reports had been completed, despite facility policies requiring these actions. Furthermore, the facility failed to offer or document the offer of bed holds to residents or their representatives upon transfer to the hospital, as required by the facility's bed hold policy. This deficiency was noted for at least one resident, with staff unable to produce documentation of the offer. The lack of documentation and communication was confirmed through record reviews and staff interviews, which consistently showed that required notifications and reports were not completed or documented for multiple residents during the review period.