Failure to Provide Written Bed-Hold Policy Notice at Hospital Transfer
Penalty
Summary
The facility failed to provide written notice of its bed-hold policy to a resident and the resident's representative upon transfer to an acute care hospital. The resident involved had diagnoses including acute respiratory failure with hypoxia, quadriplegia at C1-C4, and dependence on a ventilator. The clinical record showed the resident was discharged to an acute care hospital for surgical evaluation and an infectious disease consult related to a right hip wound infection. A Social Services Progress Note documented that the social worker notified the resident's guardian of the physician's recommendation for hospital transfer, contacted the hospital, secured a bed, and arranged transportation. However, the clinical record lacked any documented evidence that written notice of the facility's bed-hold policy was provided at the time of transfer. During interview, the Administrator stated they usually called or emailed residents and representatives to provide notification of the bed-hold policy when a resident was transferred, and that in emergent 911 transfers the priority was resident care with notification possibly occurring after the resident left. The Administrator confirmed this resident's transfer was coordinated and not emergent, recalled leaving a message for the resident's representative about paying a bed-hold fee after the transfer, and acknowledged that written notice of the bed-hold policy was not provided to the resident or representative upon transfer. The Administrator also stated the facility did not have separate policies on transfers, discharges, and bed-holds, and that related information was contained in the admission packet. The facility's Resident Admission Agreement included sections on transfers, discharges, and a bed-hold policy, including provisions for bed-hold charges and readmission rights, but there was no documentation that this required written notice was given at the time of the hospital transfer.
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