Other·March 11, 2022

F 625 Notice of Bed Hold Policy Before/Upon Transfer 483.15(d)(1)(2) §483.15(d) Notice of bed-hold policy and return- §483.15(d)(1) Notice before transfer. Before a nursing facility transfers a resident to a hospital or the resident goes on therapeutic leave, the nursing facility must provide written information to the resident or resident representative that specifies- (i) The duration of the state bed-hold policy, if any, during which the resident is permitted to return and resume residence in the nursing facility; (ii) The reserve bed payment policy in the state plan, under §447.40 of this chapter, if any; (iii) The nursing facility's policies regarding bed-hold periods, which must be consistent with paragraph (e)(1) of this section, permitting a resident to return; and (iv) The information specified in paragraph (e)(1) of this section. §483.15(d)(2) Bed-hold notice upon transfer. At the time of transfer of a resident for hospitalization or therapeutic leave, a nursing facility must provide to the resident and the resident representative written notice which specifies the duration of the bed-hold policy described in paragraph (d)(1) of this section. The facility failed to provide one of two sampled residents (Resident 1), or Resident 1's representative, of a written bed-hold notice at the time of his transfer to the acute care hospital. This failure had the potential for Resident 1 and his representative not to be aware of the bed-hold policy and the time frame during which the resident was permitted to return to the facility. The intake information sheet indicated the Department was notified on 5/20/2020 that Resident 1 had been granted an appeal for a refusal by the facility to readmit him after an extended hospital stay. Review of a record titled "Admission Record", dated 2/25/2022, revealed Resident 1 was admitted to the facility on 9/18/2018 and was transferred to the acute care on 4/13/2020, where he had been treated for a severe infection. Resident 1 had been denied readmission to the nursing facility after completion of his treatment in the acute care setting. Resident 1 was hospitalized in the acute care setting from 4/13/2020 until 5/21/2020. Review of a document titled "California Notice of Bed-Hold Policy", not dated, was signed by Resident 1's representative on 5/22/2020, after Resident 1 had won his appeal and had been readmitted to the facility. During an interview on 3/01/2022, Management Staff A confirmed the Bed Hold Policy Notice had not been given to Resident 1 or his representative at the time he was discharged to the acute care. Review of the facility document titled "Policy: Transfer and Discharge: dated "Updated March 2017", revealed "...10. In case of emergency transfer, written notice including bed hold policy and (sic) is sent to the resident/responsible party..." This failure caused or occurred under circumstances likely to cause significant humiliation, indignity, anxiety, or other emotional trauma to patients.