§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).
|
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/discharge and the reasons for the move in writing for eight of 26 sampled residents. (Residents 12, 29, 45, 49, 83, 101, 119, 126)
Findings include:
Clinical record review revealed that Resident 12 was transferred and admitted to the hospital on September 16, 2023, after a change in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 29 was transferred and admitted to the hospital on January 12, 2024, after a change in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 45 was transferred and admitted to the hospital on December 14, 2023, and December 30, 2023, after changes in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 49 was transferred and admitted to the hospital on December 29, 2023, and February 16, 2024 after changes in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 83 was transferred and admitted to the hospital on July 16, 2023, August 8, 2023, October 4, 2023, and January 19, 2024, after changes in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfers to the hospital.
Clinical record review revealed that Resident 101 was transferred and admitted to the hospital on September 30, 2023, after a change in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 119 was transferred and admitted to the hospital on January 25, 2024, after a change in condition. There was no evidence that the resident and resident's representative were provided with written information regarding the resident's transfer to the hospital.
Clinical record review revealed that Resident 126 was discharged from the facility on December 27, 2023, for "an increase in behaviors." There was no evidence that the resident and resident's representative were provided with written information regarding the discharge.
In an interview on March 8, 2024, at 12:12 p.m., the Administrator confirmed that written transfer or discharge information, including the reasons for the move, were not provided to the residents and residents' representative.
28 Pa. Code 201.29(c.3)(2)
| | Plan of Correction - To be completed: 04/16/2024
1. Residents 12, 29, 45, 49, 83, 101, 119, and 126 who returned to the facility without any difficulty were provided with the facility Transfer notice. 2. An audit of the last 30 days will be conducted of Residents transferred out of the facility to the hospital to ensure there was no barrier to their return to the facility. Resident's who were transferred out to the hospital without receiving the facility's transfer notice were provided the Transfer notice information. 3.Licensed nursing staff and Department Heads will be educated on the OPS404 Transfer and Discharge Policy by the NHA and/or Designee along with the need to provide and document the notice requirements at the time of transfer to acute care setting. 4. The NHA and/or designee will complete a weekly audit x 60 days of residents who have been transferred to the hospital to ensure transfer notice.
|
|