Failure to Provide Bed-Hold Policy Notification Upon Hospital Transfer
Penalty
Summary
The facility failed to provide written information regarding its bed-hold policy to a resident or the resident's representative prior to the resident's transfer to a hospital. According to the facility's own Bed Hold Policy, residents and/or their representatives must be informed of the policy whenever a resident is transferred for hospitalization or therapeutic leave. However, clinical record review and staff interviews confirmed that this requirement was not met for a resident who was transferred to the hospital following a verbal altercation with staff. The resident in question had been admitted with multiple diagnoses, including an intertrochanteric fracture of the left femur with surgical repair, sepsis secondary to cellulitis of the left lower extremity, and was on daily Methadone for opioid use disorder. Despite these complex medical needs, there was no documentation in the clinical record that the resident was offered a bed-hold upon transfer. Both the DON and the Administrator confirmed during interviews that the required notification was not provided.