Other·February 24, 2022

The following reflects the findings of the California Department of Public Health during the state monitoring visit. Event ID: RVLE11 Representing the Department, 2073 State Citation B was written Health and Safety Code section 1336.2 (a) Before residents are transferred due to any change in the status of the license or operation of a facility, including a facility closure or voluntary or involuntary termination of a facility's Medi-Cal or Medicare certification, the facility shall take reasonable steps to transfer affected residents safely and minimize possible transfer trauma by, at a minimum, doing all of the following: (1) Be responsible for ensuring that the resident's attending physician or the facility medical director, if the resident does not have an attending physician, completes the medical assessment of the resident's condition and susceptibility to adverse health consequences, including psychosocial effects, prior to written notice of transfer being given to the resident. The assessment shall not be considered complete unless it provides, in accordance with these assessments, recommendations for counseling, follow-up visits, and other recommended services, by designated health professionals, and for preventing or ameliorating potential adverse health consequences in the event of transfer. (2) Be responsible for ensuring that a licensed marriage and family therapist, a licensed clinical social worker, a licensed psychologist, a licensed psychiatrist, or a licensed professional clinical counselor and the facility nursing staff complete an assessment of the social and physical functioning of the resident based on the relevant portions of the minimum data set, as described in Section 14110.15 of the Welfare and Institutions Code, before written notice of transfer is given to the resident. The assessment shall not be considered complete unless it provides recommendations for preventing or ameliorating potential adverse health consequences in the event of transfer. The assessment may be amended because of a change in the resident's health care needs. The assessment shall also include a recommendation for the type of facility that would best meet the resident's needs. (3) (A) Be responsible for evaluating the relocation needs of the resident including proximity to the resident's representative and determine the most appropriate and available type of future care and services for the resident before written notice of transfer is given to the resident or the resident's representative. The health facility shall discuss the evaluation and medical assessment with the resident or the resident's representative and make the evaluation and assessment part of the medical records for transfer. (B) If the resident or resident's representative chooses to make a transfer prior to completion of assessments, the facility shall inform the resident or the resident's representative, in writing, of the importance of obtaining the assessments and follow-up consultation. (4) At least 60 days in advance of the transfer, inform the resident or the resident's representative of alternative facilities that are available and adequate to meet resident and family needs. (5) Arrange for appropriate future medical care and services, unless the resident or resident's representative has otherwise made these arrangements. This requirement does not obligate a facility to pay for future care and services. (b) The facility shall provide an appropriate team of professional staff to perform the services required in subdivision (a). (c) The facility shall also give written notice to affected residents or their representatives, advising them of the requirements in subdivision (a) at least 60 days in advance of transfer. If a facility is required to give written notice pursuant to Section 1336, then the notice shall advise the affected resident or resident's representative of the requirements in subdivision (a). If the transfer is made pursuant to subdivision (g), the notice shall include notification to the resident or resident's representative that the transfer plan is available to the resident or resident's representative free of charge upon request. On 2/4/22, at 11:30 AM, California Department of Public Health conducted an unannounced state monitoring visit at the facility to ensure the safe transfer of residents related to the facility's (Facility 1) certification termination and pending closure. The facility failed to comply with the notice requirements before transferring a resident due to facility closure by failing to provide written notice to Resident 26 at least 60 days in advance of the transfer, inform the resident of available alternative facilities that were adequate to meet resident needs and resident and family rights. Resident 26 was a 95-year-old female with diagnoses of history of fracture hip and dementia (loss of thinking, remembering, and reasoning in daily life). On 2/3/22, Resident 26 was transferred to Facility 2, located 60 miles from Bakersfield, as a result of Facility 1's pending closure. During a phone interview on 2/4/22, at 11:23 AM, with Resident 26's son (Family 1) regarding notification of his mother's transfer. Family 1 stated, he did not receive any call or letter from the facility. The only facility called was (name of Facility 2 in Tulare). Family 1 stated, (Facility 2) pressured him by telling him (Facility 1) was closing and he (Family 1) would have no choice. Family 1 stated he agreed to transfer his mother (Resident 26) to Facility 2. Explained to Family 1 of the transfer process and he should have given choices, Family 1 stated," She (Resident 26) is not a piece of luggage." During a review of Resident 26's transfer packet received from Facility 2, Resident 26 was transferred on 2/3/22 to Facility 2. There was no documentation on transfer from Facility 1. During a review of Resident 26's "Notice of Proposed Transfer and Discharge," dated 2/5/22, two days after Resident 26's transfer, Facility 1 obtained the verbal consent from Family 1. During a review of Facility 1's Accepted Relocation Plan, accepted by the Department 2/2/22, the Accepted Relocation Plan indicated, 3. The resident or the resident's representative will be included in determining the resident's new location. Evaluate, prior to written notice of transfer being given to the resident or the resident's representative...The facility shall discuss the evaluation and the medical assessment with the resident or the resident's representative ... 5. Inform, at least 60 days in advance of the transfer, the resident or resident's representative of alternative facilities that are available and adequate to meet resident and family needs...9. The facility provided written notice on 2/2/2022 to the affected residents or their representatives, advising them of the requirements in subdivision (a) of Health and Safety Code [paragraph] 1336.2 at least 60 days prior to transfer... In violation of the above cited standards, the facility failed to comply with Health and Safety Code 1336.2, including but not limited to: provide Resident 26 a written notice at least 60 days in advance of transfer, available alternative facilities that were adequate to meet resident's needs and resident and family's rights. This violation presented either imminent danger that death or serious harm would result or a substantial probability that death or serious physical harm would result.