Failure to Timely Readmit Resident Following Hospital Clearance
Penalty
Summary
A deficiency occurred when the facility failed to allow a resident to return to their previous room or to the facility in a timely manner after being cleared for discharge from the hospital. The resident, who had a history of bipolar disorder, schizoaffective disorder, intermittent explosive disorder, and other mental health conditions, was sent to the hospital due to aggressive behavior and assaulting staff. The facility's own policies required that residents sent to an acute care setting be permitted to return unless their needs could not be met, with documentation required to support any discharge decision. However, after the hospital determined the resident was stable and cleared for discharge, the facility delayed the resident's return, citing the need for a psychiatric admission and the unavailability of a private room. The medical record and hospital documentation indicated that the resident did not meet criteria for psychiatric admission and was appropriate for long-term placement. Despite this, the facility's Medical Director and admissions team refused to accept the resident back until a psychiatric admission was completed, which the hospital repeatedly stated was not indicated. Communication between the hospital and the facility was inconsistent, with the hospital case manager and liaison making multiple attempts to coordinate the resident's return. The facility also filled the resident's bed during the hospital stay and insisted on a private room for the resident upon return, further delaying the process. Interviews with facility staff revealed a lack of documentation regarding communication with the hospital and the decision-making process for readmission. The Administrator and Director of Admissions confirmed that the resident was not accepted back until the Department of Health intervened and instructed the facility to readmit the resident. The delay in readmission was not supported by clinical documentation indicating the facility could not meet the resident's needs, and the resident was ultimately returned to the facility after an extended hospital stay.