|§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 observations and interviews with residents and staff, it was determined that the facility failed to provide an appropriate discharge notice as required for one of 41 residents reviewed (Resident R73).
Interview on January 23, 2020, at 10:00 a.m. Resident R73 stated that she was upset because she received a note from the business office which indicated that she would be discharged due to owing the facility money. Interview with Resident R73's family member revealed that she found a handwritten note, written in marker across three sheets of steno pad paper on the resident's table yesterday.
Observation of the handwritten note revealed, "We need to contact your daughter. She owes us money for your stay here. If we don ' t get payment we will have to discharge you." The note included the name and phone number for the Business Office Manager.
Interview on January 23, 2020, at 2:22 p.m., the Nursing Home Administrator (NHA) stated that he was not aware of any discharge notices or billing issues for Resident R73. The NHA agreed that a handwritten note was not an acceptable means of notice to give to a resident.
Follow-up interview on January 24, 2020, at 11:23 a.m. the NHA confirmed that the paper discharge notice that was given to Resident R73 was not appropriate, that it should not have been given to her and confirmed that the resident was not being discharged from the facility.
Interview on January 24, 2020, at 12:54 p.m., the Business Office Manager stated that Resident R73's financial issues have been resolved and that the resident was not being discharged.
The facility failed to provide an appropriate discharge notice as required.
28 Pa Code 201.14(a) Responsibility of licensee
28 Pa Code 201.29(f) Resident rights
| ||Plan of Correction - To be completed: 03/08/2020|
The Business Office Manager (BOM) had an individual education completed regarding proper discharge and written notices.
R73 was spoken to and is aware that she is not being discharged from the facility.
BOM or designee will conduct a random audit of resident rooms to see if any improper postings are in resident rooms once a week for one month.
Administrator or designee will review audits weekly for one month. Any findings will be submitted to the monthly QAPI meeting for recommendations.