Facility Fails to Re-Admit Resident Post-Hospitalization
Penalty
Summary
The facility failed to re-admit a resident after a change in condition, which was identified as a deficiency. The resident, who had a history of morbid obesity, transient cerebral ischemic attack, hypertension, cognitive communication deficits, diabetes, and a urinary tract infection, exhibited aggressive behaviors such as kicking, scratching, yelling, and refusing meals and medications. On March 3, 2025, the resident was sent to the hospital due to increased aggression and was later diagnosed with an acute kidney injury and treated for a urinary tract infection. Despite the hospital's report that the resident no longer required Haldol or physical restraints, the facility refused to re-admit the resident. The hospital social worker documented that the resident had been off restraints for over 60 hours and was medically stable for discharge. However, the facility's Director of Nursing (DON) and Nursing Home Administrator (NHA) expressed concerns about the resident's stability and refused re-admission, citing inadequate documentation of the resident's condition. The facility did not provide documentation to support their decision not to re-admit the resident, nor did they collaborate with the hospital to address the resident's needs. Interviews with the DON and NHA confirmed the lack of documentation and collaboration, which contributed to the deficiency. The facility's actions were not in compliance with the regulatory requirements for permitting residents to return after hospitalization.
Plan Of Correction
The facility does and shall ensure to permit residents to return to the facility after hospitalization/therapeutic leave. The facility does and shall ensure to follow the bed hold policy permitting residents to return to the facility after hospitalization/therapeutic leave. The facility does and shall ensure to document conversations with the hospital and family regarding transfer back to the facility. Monitoring/random review will be conducted by admission director or designee and social services 1 time weekly for 3 months with findings reported to the CQI Committee for a period deemed appropriate by the CQI Committee.