§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).
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Observations:
Based on clinical record review and staff interview, it was determined that the facility failed to notify the resident's representative(s) of transfer and the reasons for the move in writing for three of 23 sampled residents. (Residents 3, 57, 72)
Findings include:
Clinical record review revealed that Resident 3 was transferred to and admitted to the hospital on November 28, 2023, after a change in condition. There was no documented evidence that the resident's responsible party was provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 57 was transferred to the hospital on January 14, 2024, after a change in condition. There was no documented evidence that the resident's responsible party was provided written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 72 was transferred to the hospital on January 9, 2024, after a change in condition. There was no documented evidence that the resident's responsible party was provided written information regarding the resident's transfer to the hospital.
In an interview on February 2, 2024, at 10:30 a.m., the Administrator confirmed that written transfer information, including the reasons for the move, was not provided to residents' representative(s).
| | Plan of Correction - To be completed: 02/23/2024
1.Unable to correct for resident 3,57,72. 2.To identify other residents that have the potential to be affected, the DON/designee reviewed 2 weeks of transfers to ER to ensure resident representative were provided written education regarding transfer to ER. 3.To prevent this from reoccurring, the licensed nurses and SSD were educated on the transfer/discharged requirements and written notification to resident representative written education regarding the residents transfer to the hospital. 4.To prevent this from reoccurring, the DON/designee reviewed transfers to ER weekly x 4 then monthly x 2 to ensure all required documentation is completed 5.Results of the audits will then be forwarded to facility QAPI for further review and recommendations.
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