Failure to Readmit Resident After Hospitalization Despite Available Beds
Penalty
Summary
The facility failed to ensure that a resident who was transferred to a General Acute Care Hospital (GACH) was readmitted to the facility after being cleared for discharge. The resident, who had diagnoses including cerebral infarction and atrial fibrillation and required moderate assistance with activities of daily living, was transferred to the hospital due to desaturation and altered mental status. Upon stabilization and clearance for discharge from the hospital, the facility denied the resident's readmission, despite having available beds and a policy stating that residents should be permitted to return upon discharge from acute care. Interviews with facility staff, including the Registered Nurse Supervisor, Admission Coordinator, Director of Nursing, and Administrator, confirmed that the resident's bed hold had expired, but there were open beds available and the resident should have been allowed to return. The Admission Coordinator and Administrator both cited the resident's outstanding share of cost as a possible reason for the denial, but acknowledged that inability to pay should not have prevented readmission. The Admission Coordinator admitted to not assisting the resident with her financial concerns or referring her to social services for help. The resident expressed significant emotional distress as a result of being denied readmission, describing feelings of sadness, anxiety, and fear about her future and her belongings left at the facility. The facility's actions resulted in the resident's temporary loss of residence and negative psychosocial outcomes, as evidenced by her vocalizations of depression and loss of trust in the facility staff.