|§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 reviews and staff interviews, it was determined that the facility failed to ensure that written notices of emergency transfers to the hospital were provided to the Office of the State Long Term Care Ombudsman for three of five residents reviewed (Residents #34, Resident #76, and Resident #87).
Review of Resident #34's nursing notes revealed a nurse entry dated March 5, 2019, indicating that the resident was admitted to the hospital with a diagnosis of bowel obstruction.
Review of Resident's #76's nursing notes revealed a note dated April 25, 2019, indicating that the resident was admitted to the hospital for possible Cerebral Vascular Accident (brain hemorrhage/stroke).
Review of Resident #87's nursing notes dated April 18, 2019, indicated that the resident was admitted to the hospital for unrelieved pain and possible infection.
Interview with Nursing Home Administrator on April 26, 2019 at approximately 8:15 a.m. revealed that the facility did not notified the State Ombudsman's office when Resident #34, #76 and Resident #87 were transferred to the hospital.
28 Pa Code 201.14(a) Responsibility of Licensee
28 Pa Code 201.18(e)(1) Management
| ||Plan of Correction - To be completed: 06/21/2019|
1. Residents #34, #76 and #87 were reported on the May 2019 monthly report to the Office of the State Long-Term Care Ombudsman.
2. An audit will be done of all residents transferred to the hospital in April 2019 to ensure that all transfers have been reported.
3. The Administrator will conduct an audit monthly x3, and then quarterly, to ensure that transfers and discharged residents are reported timely to the Office of the State Long-Term Care Ombudsman per the reporting algorithm.
4. The Regional Vice President will re-educate the Center Executive Director on reporting transfers and discharges timely to the Office of the State Long-Term Care Ombudsman per the reporting algorithm. The Center Executive Director/designee is responsible for reporting.
5. The Administrator/ designee will review the results of the audits at the Facility's Quality Improvement Meeting x3 months.