Failure to Honor Resident's Preference for Private Pay Stay After Medicare Coverage Ends
Penalty
Summary
The facility failed to facilitate non-discriminatory discharge planning that met a resident's preferences by not allowing the resident to remain in the facility as a private pay resident after her Medicare coverage ended. Despite the resident and her family expressing a clear desire for her to stay and pay privately, facility staff informed them that there would be no bed available after her Medicare days ran out. Documentation and interviews revealed that the facility was licensed and certified for 140 Medicaid/Private Pay beds, with a current census of 130 residents and 29 available beds. However, the administrator stated that the facility was only accepting up to 82 long-term care residents based on instructions from the CFO, citing profit motives, and had only accepted hospice or respite residents since May 2025. The social service director and admissions director both confirmed that the resident and her family were told there was no bed available, despite documentation showing otherwise. The resident's care plan indicated a need for increased communication and participation in care planning, but the facility did not honor the resident's preference to remain as a private pay resident. The facility's own brochure on residents' rights states that residents have the right to keep living in the facility, yet the resident was scheduled for discharge to an undetermined facility against her and her family's wishes.