Failure to Provide Required 30-Day Discharge Notice and Appeal Rights
Penalty
Summary
The facility failed to provide a resident or the resident's representative with a 30-day written notice prior to discharge, as required. The clinical record review showed that the resident, who had diagnoses including heart failure, diabetes, and unsteadiness, required varying levels of assistance with daily activities and had intact cognition. Documentation in the electronic health record indicated that the resident was informed of the last day of therapy and had plans to return home, with subsequent orders for discharge and therapy at a new facility. However, there was no evidence that a formal discharge notice, including required information about appeal rights, was given. The discharge instructions provided to the resident included details about the discharge location, responsible party, primary physicians, pharmacy, and some care instructions. The document was signed by the resident, the MDS Coordinator, and the social worker. Despite this, the instructions did not constitute a 30-day notice and did not include information on the right to appeal the discharge, the process for appealing, or contact information for the state entity responsible for appeals. During an interview, the Administrator confirmed that the only policy related to discharges was the bed hold policy and that the resident's wife was provided with discharge instructions, but no other form was given. The facility's bed hold and return policy was reviewed, but it did not address the requirements for discharge notice or appeal rights. The lack of proper notice and appeal information constituted the deficiency identified during the survey.