|§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, a review of facility policy and documentation and interviews with staff, it was determined that the facility failed to notify the Office of the State Long-Term Care Ombudsman of facility-initiated emergency transfers and discharges for one of three closed records reviewed (Residents R46).
A review of the Transfer and Discharge policy revealed that a copy of the discharge notice shall be provided to a representative of the Office of the State Long-Term Care Ombudsman.
Clinical record review for Resident R46 revealed that resident was admitted to the facility on May 3, 2022, with diagnoses including liver cell carcinoma (cancer that starts in the liver) and chronic viral hepatitis C (a viral infection that causes inflammation of liver).
Continued record review for Resident R46 revealed progress notes, dated May 31, 2022, at 2:26 p.m., indicating that the resident's sister was adamant that the resident be sent to the hospital and that the nurse practitioner agreed to send resident out to the hospital to be checked out. Resident left via stretcher with two ambulance attendants. A copy of bed hold policy was faxed to the hospital. All personal belongings remain safe and secure in resident room, and the medication disposition was completed.
An interview on June 13, 2022, at approximately 2:00 p.m. with the Administrator, Employee E1, confirmed that according to the Social Worker, Employee E10, the Long-Term Care Ombudsman was not informed of the transfers and discharges for the past few months.
The facility failed to notify the Office of the State Long-Term Care Ombudsman of facility-initiated emergency transfers and discharges.
CFRNotice before transfer.
28 Pa. Code 201.14(a) Responsibility of licensee
| ||Plan of Correction - To be completed: 07/26/2022|
Disclaimer: Facility submits this plan of correction under procedures established by the Department of Health in order to comply with the Department's directive to change conditions which the Department alleges are deficient under State and Federal Regulations relating to long term care. This should not be construed as either a waiver of the Facility's right to appeal and to challenge the accuracy or severity of the alleged deficiencies or any admission of any wrongdoing or an admission of past or ongoing violations of State and Federal Regulations.
Facility initiated emergency transfer and discharge for Resident R46 will be reported to the Office of the Long-Term Care Ombudsman
All emergency transfers and discharges for the last 3 months will be reviewed and reported to the Office of the Long-Term Care Ombudsman
Education was provided to the social services department on communicating with the Office of the Long-Term Care Ombudsman of all facility initiated emergency transfers and discharges.
Social Worker/designee will audit monthly x 6 to ensure all facility initiated emergency transfers and discharges have been communicated with the Office of the Long-Term Care Ombudsman.
Audit findings will be reported to the QA Committee monthly x 6 for further recommendations