Failure to Readmit Resident After Hospital Clearance
Penalty
Summary
The facility failed to ensure that a resident, who had diagnoses including generalized muscle weakness and paraplegia, was readmitted after being cleared for return from a general acute care hospital. The resident had left the facility without notifying staff, returned the same day, and was subsequently sent to the hospital due to alcohol intoxication. Despite being cleared by the hospital for return, the facility denied readmission, citing the resident's altered mental status and considering the situation as an 'Against Medical Advice' (AMA) discharge, even though the resident did not sign an AMA form. Interviews with facility staff revealed inconsistent application of AMA procedures and a lack of clear documentation regarding the resident's discharge status. The resident remained at the hospital after being denied readmission, resulting in a temporary loss of residence and reported emotional distress. Facility records and staff interviews confirmed that the discharge was initiated by the facility after the resident returned intoxicated, and that the facility's policy allows for return after emergency hospital transfers unless a facility-initiated discharge is warranted. The facility's actions did not align with their own policy, as the resident was not permitted to return despite being cleared by the hospital and not having formally left AMA.