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F0580
D

Failure to Notify POA of Resident Hospitalization

Mentor, Ohio Survey Completed on 12-10-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to timely notify the appropriate family member, specifically the resident's Power of Attorney (POA), regarding a resident's hospitalization. The resident, who had diagnoses including COPD, a displaced fracture of the left femur, an open wound to the left hip, diabetes, a left artificial hip, and peripheral vascular disease, was admitted to the facility and later transferred to the hospital after calling 911 due to feeling scared. Emergency Medical Services (EMS) responded and, at the resident's request, transported her to the hospital for evaluation. Documentation showed that the resident's spouse was notified of the transfer, but there was no evidence that the POA, listed as the primary emergency contact, was informed. Additionally, the medical record review revealed that no change of condition form was completed for this event. The Director of Nursing (DON) confirmed during an interview that the required notification to the POA was not made and that the change of condition form was not filled out. This deficiency affected one resident out of three reviewed for change in condition, in a facility with a census of 80.

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