Failure to Honor Bed-Hold Rights and Readmit Resident to Reserved Bed
Penalty
Summary
The deficiency involves the facility’s failure to honor a resident’s right to return to their reserved bed following a hospitalization within the state-defined bed-hold period. The resident, who had dementia with severe cognitive impairment and polyneuropathy, required assistance with transfers, dressing, hygiene, and bed mobility. The resident had been initially admitted and later readmitted to the facility and was residing in a specific room and bed (Bed AA), which was placed on a seven-day bed hold when the resident was transferred to a general acute care hospital (GACH) for escalating dementia. The DON confirmed that the resident’s discharge date from GACH fell within this seven-day bed-hold period and that it was the resident’s right to return to the same room and bed. Instead of readmitting the resident to the facility, the Administrator requested that the resident be placed at another SNF (SNF 2), citing an isolated incident of sexual abuse involving the resident and stating that SNF 2 was more appropriate to care for the resident. The Admissions Director at SNF 2 reported that the referral came from the facility’s marketer (MK) and that no reason for the transfer was provided other than a request to take the resident “for now.” The GACH case manager stated that the transfer request to SNF 2 did not come from the resident or the resident’s family representative, but from the facility’s MK, who reported that the building was undergoing remodeling due to water damage and that the resident’s room needed remodeling, necessitating a temporary transfer. GACH documentation reflected that, according to the facility, there was a problem at the facility and that the resident would be sent temporarily to a sister facility due to building construction from rain damage, with the family allegedly made aware. Subsequent observations and interviews did not support the stated reason of remodeling for denying the resident’s return. Surveyors observed no remodeling or maintenance in the resident’s former room, and the Maintenance Supervisor confirmed that only other specified rooms were undergoing drywall replacement due to leaks, with no work needed in the resident’s room. The DON stated that the resident was on a seven-day bed hold and had the right to return to the facility and to the same room and bed, and that she was not notified on the day the resident was transferred to SNF 2, so she could not verify bed availability. The DON also stated she was unaware that SNF 2 was not a locked facility and that SNF 2 should have been informed of the resident’s behavior before accepting the transfer. The facility’s bed-hold policy stated that residents returning within the bed-hold period are allowed to return to their previous room if available and that post-hospitalization evaluations should be based on the resident’s current condition. Despite this, the resident was not readmitted to the reserved bed and was instead discharged from GACH to another SNF within the bed-hold period.
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