Failure to Provide Required Written Transfer/Discharge Notice to Resident Representative
Penalty
Summary
The facility failed to provide written notice of transfer or discharge, including the reasons for the move, to a resident and the resident’s representative in a language and manner they understood prior to the transfer. A male resident with diagnoses including cerebral infarction, Alzheimer’s disease, and hypertensive heart/chronic kidney disease was admitted with an anticipated dual certification status and placement on the skilled side, with hospice and physical therapy services expected. After admission, the facility’s assessment determined the resident did not meet qualifications for hospice and physical therapy services, which changed the services to be provided. The resident’s record showed a discharge after a one-day stay, with transfer by ambulance to another facility with hospice services, but there was no documentation of a physician order for the transfer or any written notice to the resident or representative explaining the reason for the move. During interviews, the resident’s family member stated she did not sign any documents or agree to the transfer and that she was informed of the move only by the hospice company, not by the facility. The administrator reported that, after determining the resident did not qualify for hospice and physical therapy, he spoke with the hospice company and concluded the resident could not remain, and he acknowledged having no physician order or family approval documentation for the transfer. He stated he believed the hospice liaison should have handled all aspects of the transfer, including documentation. The hospice liaison reported that the administrator repeatedly called insisting the resident be removed, stating it was the hospice company’s responsibility, and that the process for transfer was not followed. Facility policy titled “Your Rights and Protections as a nursing home resident” stated the nursing home must safely and orderly transfer or discharge residents and provide proper notice of bed-hold and/or readmission requirements, which was not reflected in the documentation for this resident’s transfer.
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