The facility failed to provide the required written transfer notice to residents or their RRs after emergent hospital transfers for two residents. One resident was transferred after extreme agitation and ineffective PRN medication, and another was transferred after lethargy and severe hypotension with 911 transport to the ED. The Consultant Admin stated transfer notice forms were not being sent to residents or families, and the DON stated the notice should be provided when a discharge occurred.
Failure to provide bed hold and transfer notices after hospital transfers for three cognitively intact residents. One resident was transferred after a fall and later for increased behaviors, another was sent out after becoming unresponsive, and a third was sent out for a change in condition; in each case, the required notice was not given to the resident or RR in a timely manner, and one notice was sent to the Ombudsman instead of the resident.
A facility failed to include the bed hold reserve payment amount in written emergency transfer notices for 3 residents who were hospitalized. The transfer letters stated that each resident was entitled to a 10-day bed-hold privilege, but they did not list the reserve payment amount and also referenced insurance the facility did not participate in. One resident had DM and HF, another had orthopedic aftercare and a humerus fracture, and a third had AFib and hypertensive heart disease with HF.
A resident with influenza, dysphagia, seizures, heart disease, and dementia was transferred to the hospital for respiratory distress, increased lethargy, and low O2 levels. The facility did not notify the Ombudsman of the emergency transfer and did not provide the bed hold policy to the resident or representative, despite policies requiring written bed-hold information at transfer or within 24 hours and documentation of Ombudsman notification.
The facility failed to provide written bed-hold and reserve bed payment information to resident representatives after hospital transfers for three residents. One resident had severe cognitive impairment and was transferred for hypernatremia and sepsis, while two others with moderate to severe cognitive impairment were transferred for G-tube dislodgement and shortness of breath. Records showed transfer notices were sent, but no written bed-hold policy notifications were documented, and the AD stated the facility did not have an official bed-hold letter.
The facility failed to include required bed-hold reserve payment information, LTCO information, and appeal rights in written transfer notices sent to the RR for two residents after hospital transfers. Both residents had intact cognition per MDS/BIMS, and the letters only stated the hospital transfer and attached a bed-hold policy notice. The DoAaCM said the price was not on the letter, and the LNHA later stated the notice had been changed to include the appeal process and reserve payment.
A resident with chronic respiratory failure, tracheostomy status, and persistent vegetative state was sent to the hospital after family reported facial swelling and an NP ordered further evaluation. The facility did not document providing the resident or RR with the required written transfer notice or bed hold notice, and the SSD confirmed the information was not sent to the RR.
Failure to Notify Ombudsman of Hospital Transfer: A resident with acute respiratory failure, COPD, HF, and DM2 was sent to the ER for a low platelet count after the MD was contacted about a lab decline. The resident’s representative was notified and transport was arranged, but the facility did not notify the State LTC Ombudsman at the same time the transfer notice was given, as required.
A resident with a history including TIA, cerebral infarction, atrial fibrillation, traumatic subdural hemorrhage, and dementia had an unplanned hospital transfer and was admitted with an intracranial hematoma. The record contained no evidence that the resident or resident representative received written bed hold notification. The DSS and LNHA stated that bed hold notices were only provided to LTC residents, and the LNHA further stated the notice was only for Medicaid residents.
Two residents with BIMS scores of 15/15 were sent to the hospital, but the facility did not provide transfer notices that included the required appeal process and bed hold information. One resident’s transfer notice omitted the appeal process, while the other resident’s form listed only Ombudsman office information as the appeals contact. The SW said residents were not given copies of the transfer form because they knew they were going out, and the DON said this was the form the facility always used.
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