Every finding on record at Helen Hayes Hospital T C U

Based on record review and interview conducted during a recertification survey, the facility did not ensure for 1 of 1 resident reviewed for hospitalization that the resident or her representatives were given timely written notification of a transfer and the reasons for the move in a language and manner they could understand. This was evident for 1 of 2 residents reviewed for closed record. The finding is: Resident #9 was an [AGE] year old female admitted on [DATE] with [DIAGNOSES REDACTED]. The 5-day Scheduled Minimum Data Set (a resident assessment and screening tool) of 2/2/18 indicated the resident was cognitively alert. The progress notes of 2/4/18 at 7:45 AM documented that the resident complained of shortness of breath. The oxygen saturation (a measure of the blood oxygen level) was checked and the results were 60 to 65% (normal range is 90-100%). The resident received respiratory treatment and was placed on a venturi mask (medical device to deliver a set concentration of oxygen). The oxygen saturation level then increased to 90%. The resident stated she felt better but the shortness of breath persisted. The resident received a medication to improve her breathing status. Arterial blood gases were performed and the oxygen level was 70%. The resident was sent to the hospital for further evaluation and left the facility in guarded condition. Review of the medical record revealed no documented evidence that the resident or her representative received written notification of the transfer on 2/4/18. The Registered Nurse/Administrator was interviewed on 2/7/18 at 2:00 PM and she stated she had not provided the resident or her representative with a transfer notice. 415.3(h)(1)(iii)(a-e)

Based on record review and interview conducted during a recertification survey, the facility did not ensure for 1 of 1 resident reviewed for hospitalization that the resident or her representatives were given timely written notification of the bed hold policy before transfer in a language and manner they could understand. This was evident for 1 of 2 residents reviewed for hospitalization . ( Resident #9). The finding is: Resident #9 was an [AGE] year old female admitted on [DATE] with [DIAGNOSES REDACTED]. The 5-day Scheduled Minimum Data Set (MDS; a resident assessment and screening tool) of 2/2/18 indicated the resident is cognitively alert. The progress notes of 2/4/18 at 7:45 AM documented that the resident complained of shortness of breath. The oxygen saturation (a measure of the blood oxygen level) was checked and the results were 60 to 65% (normal range is 90-100%). The resident received a respiratory treatment and was placed on a venturi mask (medical device to deliver a set concentration of oxygen). The oxygen saturation level then increased to 90%. The resident stated she felt better but the shortness of breath persisted. The resident received medication to improve her breathing status. Arterial blood gases were performed and the oxygen level was 70%. The resident was sent to the hospital for further evaluation and left the facility in guarded condition. Review of the medical record revealed no documented evidence that the resident or her representative received written notification about the facility's bed hold policy prior to the transfer on 2/4/18. In an interview with the Registered Nurse/Administrator on 2/7/18 at 2:00 PM she stated she had not provided the resident or her representative with a notice of the bed hold policy. 415.3(h)(1)(iii)(a-e)

Based on observation, record review and interview conducted during a recertification survey, the facility did not ensure that care was provided to maintain dignity for 1 of 1 resident (#202) reviewed for dignity. Specifically, the resident's urine collection bag and tubing were not concealed to prevent direct observations by other residents and visitors. Findings are: Resident #202 has [DIAGNOSES REDACTED]. The nursing and physician documentation on the interdisciplinary progress notes of 4/07/17 revealed the resident was given a post-void residual urine test (measures the amount of urine left in the bladder after urination). The physician then ordered to insert an indwelling urinary catheter to assist her in voiding after consultation with the resident and her family. Four-hundred milliliter of urine was observed in the urine collecting bag which suggested the resident was retaining urine. During the three days of the recertification survey from 4/11/17 through 4/13/17, at various times of the day, the resident was observed in the hallway seated in her wheelchair with an exposed urine collecting bag beneath the seat of the wheelchair which was visible to other residents and visitors. The resident was transported to Physical Therapy department in this manner during these three days in addition to going outside the facility during a visit with a relative. The resident was interviewed on 4/13/17 at 11:15 AM and stated she felt that she did not need the catheter. The resident stated she believed that she had a urinary tract infection and this was the reason why she was retaining urine. The unit Registered Nurse (RN) head nurse was interviewed on 4/13/17 at 11:20 AM and was asked about ways to conceal the urine collecting bag. The RN head nurse sated that she had never seen a covering for a urine bag used before in this facility. The RN head nurse stated that it might be a good idea to have the urine collecting bag covered to enhance and promote the resident's dignity. The Director of Nursing was interviewed on 4/13/17 at 11:35 AM and stated that the facility staff has never provided a covering for a urinary catheter bag for residents. Following surveyor inquiry, the DON stated that she would immediately check with the facility supply department to obtain a cover for the urine collecting bag for the resident. 415.5(a)