Failure to Provide Required Bed-Hold Notification and Documentation During Resident Transfers
Penalty
Summary
The facility failed to provide written notification of the reason for transfer or discharge, as well as documentation of the bed-hold policy and the rate to reserve a resident's bed, for two residents who were transferred to the hospital on multiple occasions. According to the facility's own policy, residents and/or their representatives are to receive written information about bed-hold practices both at admission and at the time of transfer, including the duration of the state bed-hold policy, the reserve bed payment policy, and the facility's own policies regarding bed-hold periods. The policy also requires that a signed and dated copy of the bed-hold notice be kept in the resident's file and that this information be provided to all residents regardless of payment source. For one resident with diagnoses including quadriplegia, depressive disorder, hypertension, and anxiety disorder, the medical record review revealed multiple hospital transfers due to acute medical issues such as abdominal pain and suspected bowel obstruction. On several occasions, the Bed Hold Policy and Notice of Transfer forms were either incomplete or missing entirely. Required sections such as the bed hold policy, time period for room reservation, current daily rate, and signatures were not filled out. There was no evidence that the resident or their representative received the written bed-hold policy and notice of transfer as required by facility policy. A second resident, who has acute and chronic respiratory failure, COPD, diabetes, hypertension, and depression, also experienced multiple hospital transfers for conditions including respiratory distress, anemia, and colon cancer surgery. The surveyor was unable to locate completed bed-hold policy and notice of transfer forms for several of these transfers. Interviews with staff revealed inconsistent practices regarding the completion and distribution of these forms, with some staff unaware of the required bed-hold rates and others not providing the forms at all. The resident and her husband both confirmed they did not receive the required documentation. The forms in use at the time were also found to be missing the daily bed-hold rate, contrary to policy requirements.