Failure to Provide Required Written Bed-Hold Notices Upon Hospital Transfer
Penalty
Summary
The facility failed to provide required written bed-hold notices to residents or their representatives upon transfer to the hospital, as required by its "Bed Hold and Returns Policy." That policy stated that prior to a transfer, written information must be given to residents and their representatives explaining the rights and limitations regarding bed holds, the state plan reserve bed payment policy, and the facility per diem rate to hold a bed or extend a bed hold. For one resident with a BIMS score of 07 indicating moderate cognitive impairment, records showed he was his own responsible party and was transferred to the hospital, where he remained until his death. Review of his clinical record, including progress notes, revealed no evidence that a bed-hold notice was provided on or around the dates of transfer and hospitalization. The DON acknowledged that the facility did not provide a written bed-hold notice before or on the date of transfer, and the Administrator confirmed there was no record of such a notice being given. For a second resident with a BIMS score of 10, also indicating moderate cognitive impairment, the face sheet identified the resident’s sister as the primary emergency contact and next of kin. Progress notes documented that this resident was transferred to the hospital, but the documentation lacked confirmation that the bed-hold notice was reviewed with or signed by either the resident or the sister on the day of transfer. In a joint interview, the DON and Administrator confirmed there was no documentation that the bed-hold policy was reviewed with or provided to the resident or the resident’s representative at the time of transfer. These findings showed that, for both residents reviewed for hospitalizations, the facility did not follow its own policy requiring written bed-hold information prior to transfer.
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