The Sequoias-portola Valley

Health screening and fitness requirements

Based on record review, the licensee did not ensure that S1 had TB results which poses an immediate health, safety or personal rights risk to persons in care.

Maintain separate complete record for each resident

Based on records review , the licensee did not comply with the section cited above in 4out of 4 resident files reviewed, which poses a potential health, safety or personal rights risk to persons in care.

Provisions of Contract - (a) A continuing care contract shall contain all of the following: (10) The procedures and conditions under which a resident may be voluntarily andinvoluntarily transferred from a designated living unit. The transfer procedures, at aminimum, shall include provisions addressing all of the following circumstances underwhich a transfer may be authorized:(A) A continuing care retirement community may transfer a resident under thefollowing conditions, taking into account the appropriateness and necessity of thetransfer and the goal of promoting resident independence:(i) The resident is nonambulatory. The definition of "nonambulatory," as providedin Section 13131, shall either be stated in full in the continuing care contract or becited. If Section 13131 is cited, a copy of the statute shall be made available to theresident, either as an attachment to the continuing care contract or by specifying that itwill be provided upon request. If a nonambulatory resident occupies a room that has afire clearance for nonambulatory residents, transfer shall not be necessary.(ii) The resident develops a physical or mental condition that is detrimental to orendangers the health, safety, or well-being of the resident or another person.(iii) The resident's condition or needs require the resident's transfer to an assistedliving care unit or skilled nursing facility, because the level of care required by theresident exceeds that which may be appropriately provided in the living unit.(iv) The resident's condition or needs require the resident's transfer to a nursingfacility, hospital, or other facility, and the provider has no facilities available toprovide that level of care.(B) Before the continuing care retirement community transfers a resident under anyof the conditions set forth in subparagraph (A), the community shall satisfy all of thefollowing requirements:(i) Involve the resident and the resident's responsible person, as defined inparagraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code ofRegulations, and upon the resident's or responsible person's request, family members,or the resident's physician or other appropriate health professional, in the assessmentprocess that forms the basis for the level of care transfer decision by the provider. Theprovider shall offer an explanation of the assessment process, which shall include, butnot be limited to, an evaluation of the physical and cognitive capacities of the resident.An assessment tool or tools, including scoring and evaluating criteria, shall be used inthe determination of the appropriateness of the transfer. The provider shall makecopies of the completed assessment to share with the resident or the resident'sresponsible person.(ii) Prior to sending a formal notification of transfer, the provider shall conduct acare conference with the resident and the resident's responsible person, and, upon theresident's or responsible person's request, family members, and the resident's healthcare professionals, to explain the reasons for transfer.(iii) Notify the resident and the resident's responsible person of the reasons for thetransfer in writing.51(iv) Notwithstanding any other provision of this subparagraph, if the resident doesnot have impairment of cognitive abilities, the resident may request that his or herresponsible person not be involved in the transfer process.(v) The notice of transfer shall be made at least 30 days before the transfer isexpected to occur, except when the health or safety of the resident or other residents isin danger, or the transfer is required by the resident's urgent medical needs. Underthose circumstances, the written notice shall be made as soon as practicable before thetransfer.(vi) The written notice shall contain the reasons for the transfer, the effective date,the designated level of care or location to which the resident will be transferred, astatement of the resident's right to a review of the transfer decision at a careconference, as provided for in subparagraph (C), and for disputed transfer decisions,the right to review by the Continuing Care Contracts Branch of the State Departmentof Social Services, as provided for in subparagraph (D). The notice shall also containthe name, address, and telephone number of the department's Continuing CareContracts Branch.(vii) The continuing care retirement community shall provide sufficient preparationand orientation to the resident to ensure a safe and orderly transfer and to minimizetrauma.(viii) For disputed transfer decisions, the provider shall provide documentation ofthe resident’s medical reports, other documents showing the resident’s current mentaland physical function, the prognosis, and the expected duration of relevant conditions,if applicable. The documentation shall include an explanation of how the criteria setout in subparagraph (A) are met. The provider shall make copies of the completedreport to share with the resident’s responsible person.(C) The resident has the right to review the transfer decision at a subsequent careconference that shall include the resident, the resident's responsible person, and, uponthe resident's or responsible person's request, family members, the resident's physicianor other appropriate health care professional, and members of the provider'sinterdisciplinary team. The local ombudsperson may also be included in the careconference, upon the request of the resident, the resident's responsible person, or theprovider. This health and safety code requirement has not been met as evidenced by: Facility did not follow the rules as outlined in HSC 1788(a)(10)(A)-(C) regarding resident trasfers.