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F0627
D

Failure to Ensure Safe and Appropriate Discharge Planning

East Stroudsburg, Pennsylvania Survey Completed on 08-15-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that a resident's discharge was appropriate and necessary, as required by regulations. Clinical record review showed that a resident with acute kidney failure and unsteadiness, who had previously been hospitalized due to an inability to care for herself, was discharged home. The Minimum Data Set Assessment indicated the resident was cognitively intact, but there was documented evidence from the Area Agency on Aging that upon returning home, the resident had no food available except for ice cubes in the refrigerator/freezer. Social service notes indicated that discharge planning was discussed with the resident's family, but there was no documentation detailing how the family would assist the resident in obtaining food or other necessary services to support her transition home. Interviews with the Director of Social Services confirmed the lack of documented evidence that the resident would receive the required care and services to ensure a safe discharge. The facility did not demonstrate that the discharge was safe and appropriate, as required by state regulations.

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