|§483.15(c)(3) Notice before transfer. |
Before a facility transfers or discharges a resident, the facility must-
(i) Notify the resident and the resident's representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand. The facility must send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman.
(ii) Record the reasons for the transfer or discharge in the resident's medical record in accordance with paragraph (c)(2) of this section; and
(iii) Include in the notice the items described in paragraph (c)(5) of this section.
§483.15(c)(4) Timing of the notice.
(i) Except as specified in paragraphs (c)(4)(ii) and (c)(8) of this section, the notice of transfer or discharge required under this section must be made by the facility at least 30 days before the resident is transferred or discharged.
(ii) Notice must be made as soon as practicable before transfer or discharge when-
(A) The safety of individuals in the facility would be endangered under paragraph (c)(1)(i)(C) of this section;
(B) The health of individuals in the facility would be endangered, under paragraph (c)(1)(i)(D) of this section;
(C) The resident's health improves sufficiently to allow a more immediate transfer or discharge, under paragraph (c)(1)(i)(B) of this section;
(D) An immediate transfer or discharge is required by the resident's urgent medical needs, under paragraph (c)(1)(i)(A) of this section; or
(E) A resident has not resided in the facility for 30 days.
§483.15(c)(5) Contents of the notice. The written notice specified in paragraph (c)(3) of this section must include the following:
(i) The reason for transfer or discharge;
(ii) The effective date of transfer or discharge;
(iii) The location to which the resident is transferred or discharged;
(iv) A statement of the resident's appeal rights, including the name, address (mailing and email), and telephone number of the entity which receives such requests; and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request;
(v) The name, address (mailing and email) and telephone number of the Office of the State Long-Term Care Ombudsman;
(vi) For nursing facility residents with intellectual and developmental disabilities or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with developmental disabilities established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (Pub. L. 106-402, codified at 42 U.S.C. 15001 et seq.); and
(vii) For nursing facility residents with a mental disorder or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act.
§483.15(c)(6) Changes to the notice.
If the information in the notice changes prior to effecting the transfer or discharge, the facility must update the recipients of the notice as soon as practicable once the updated information becomes available.
§483.15(c)(8) Notice in advance of facility closure
In the case of facility closure, the individual who is the administrator of the facility must provide written notification prior to the impending closure to the State Survey Agency, the Office of the State Long-Term Care Ombudsman, residents of the facility, and the resident representatives, as well as the plan for the transfer and adequate relocation of the residents, as required at § 483.70(l).
Based on clinical record review and staff interview, it was determined that the facility failed to ensure that a written notice of transfer to the hospital was provided to the resident and the residents' representative for six of six residents reviewed for transfer to the hospital. (Residents 81, 47, 6, 25, 67, and Resident 23 )
A review of the clinical record revealed that Resident 81 was transferred and admitted to the hospital on December 12, 2018, and returned to the facility on December 17, 2018.
A review of Resident 47's clinical record revealed that the resident was transferred and admitted to the hospital on November 12, 2018, and returned to the facility on November 16, 2018.
Resident 6 was transferred to the hospital on January 8, 2019, and admitted he returned to the facility on January 10, 2019.
Resident 25 was transferred to the hospital on November 6, 2018, and admitted, he returned to the facility on November 8, 2018.
Resident 67 was transferred to the hospital on November 16, 2019, and was admitted, he returned to the facility on November 19, 2018.
Resident 23 was transferred and admitted to the hospital on October 13, 2018 and returned to the facility on October 19, 2018.
Further clinical record reviews revealed no evidence that a written notice was provided to the above residents and their representatives regarding the transfer that included the required contents: reason for the transfer, contact and address information for the Office of the State Long-Term Care Ombudsman, and if applicable, information for the agency responsible for the protection and advocacy of individuals with developmental disabilities.
Interview with the Director of Nursing on January 31, 2019, at approximately 11:00 AM verified that the facility did not send written notices to the resident and their residents' representatives of the facility initiated transfers of the above residents, but does send a monthly report to the State Ombudsman of facility initiated transfers.
28 Pa. Code 201.14(a) Responsibility of Licensee
28 Pa. Code 201.29(i) Resident rights
| ||Plan of Correction - To be completed: 03/26/2019|
The facility cannot retroactively issue written notices of transfer to the hospital for residents # 81, 47, 6, 25, 67, and 23.
Our current bed hold transfer /therapeutic notification form was amended to include the reason for the facility initiated transfer to the hospital in a language that the resident and representative could understand and the hospital to which the resident was transferred.
The facility will ensure that a written notice of transfer to the hospital is provided to the resident and the resident representative which will include the reason for hospitalization in a language both the resident/representative can understand.
The Director of Nursing is in the process of inservicing all licensed staff on the changes to the Bed Hold Transfer/therapeutic Leave Notification form with focus of providing the reason for transfer to the hospital in a language the resident/representative can understand.
The quality assurance committee designee will do a weekly audit of bed hold/transfer /therapeutic leave notification forms to ensure that a written notice of transfer to the hospital was provided to the resident and representative in a language they could understand. The audit will be reviewed at the next quarterly QA committee meeting to evaluate our compliance with determination to discontinue the audit or alter the need for future audits.