Health inspection·August 21, 2024

Harvest Crossing Post Acute The following reflects the findings of the California Department of Public Health during the investigation of: Complaint # CA00895016 Survey Event ID: IOHR11 State Citation B was written. Code of Federal Regulations, Title 42, Section §483.15(c)(3) (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. California Health and Safety Code, 1439.6 (a)(c)(d) (a) Except as provided in subdivision (b), if a resident is notified in writing of a facility-initiated transfer or discharge from a long-term health care facility, the facility shall also send a copy of the notice to the local long-term care ombudsman at the same time notice is provided to the resident or the resident's representative. (c) The copy of the notice shall be sent by fax machine or email, as may be directed by the local long-term care ombudsman, unless the facility does not have fax or email capability, in which case the copy of the notice shall be sent by first-class mail, postage prepaid. A facility's failure to timely send a copy of the notice shall constitute a class B violation, as defined in subdivision (e) of Section 1424. (d) For the purposes of this section, a "facility-initiated transfer or discharge" is a transfer or discharge that is initiated by the facility and not by the resident, whether or not the resident agrees to the facility's decision. On 4/16/24 at 9:45 a.m., the California Department of Public Health (CDPH) conducted an unannounced visit at the facility to investigate a complaint regarding discharge. The Department determined the facility failed to provide notice of a facility-initiated discharge to the appropriate parties when the facility did not inform the Office of the State Long-Term Care Ombudsman on the same day the facility served Patient 1 with a 30-Day Notice of Transfer or Discharge form. This failure could have resulted in Patient 1 not having access to an advocate to inform Patient 1 of her options for an appeal. Review of Patient 1's clinical record titled, "Admission Record," indicated, Patient 1's diagnosis included difficulty walking and muscle weakness. During a review of Patient 1's clinical record titled, "30 DAY NOTICE OF TRANSFER OR DISCHARGE," dated 2/21/24, signed by the Administrator (ADM) and Patient 1, the record indicated, "...This is to inform you, [Patient 1], will be transferred/discharged on or before March 21, 2024, for the following reason(s): Refusal of payment of your Share of Cost [portion of money owed by the patient]..." During a concurrent interview and record review on 4/16/24, at 10:30 a.m., with the Director of Nursing (DON), the document titled, "Cover Sheet [fax cover sheet]," dated 2/26/24, by the ADM, was reviewed. The document indicated the facility faxed Patient 1's 30-Day Notice of Transfer or Discharge Notice form to the Ombudsman on 2/26/24 and the DON stated the Ombudsman was not notified the same day the notice was given to Patient 1. During a joint interview on 4/16/24, at 12:55 p.m., with the ADM and DON, the ADM stated Patient 1 was given the 30-Day Notice of Transfer or Discharge form on 2/21/24 and the facility notified the Ombudsman on 2/26/24. The ADM stated he was unaware the Ombudsman was supposed to be notified the same day Patient 1 was given the 30-Day Notice of Transfer or Discharge form until he was informed by the DON. The DON stated it was important to notify the Ombudsman immediately upon serving Patient 1 with the 30-Day Notice of Transfer or Discharge form because the Ombudsman would act as an advocate for Patient 1 and could have assisted with the appeal process. During a phone interview on 4/18/24, at 8:30 a.m., the Ombudsman (OMB), stated she visited Patient 1 on 3/27/24 and Patient 1 expressed feelings of not wanting to leave the facility because she had friends at the facility and participated in a lot of activities. The OMB stated because the Notice of 30-Day Transfer or Discharge form was not faxed the same day to the Ombudsman's office, Patient 1 did not get a chance to meet with an Ombudsman to file another appeal with the court to remain in the facility. Therefore, the Department determined the facility failed to provide notice of a facility-initiated discharge to the appropriate parties when the facility did not inform the Office of the State Long-Term Care Ombudsman on the same day the facility served Patient 1 with a 30-Day Notice of Transfer or Discharge form. This failure could have resulted in Patient 1 not having access to an advocate to inform Patient 1 of her options for an appeal. This violation had a direct or immediate relationship to the health, safety, or security of Patient 1.