Failure to Permit Resident Return After Hospitalization
Penalty
Summary
The facility failed to establish and follow a written policy regarding the return of a resident after hospitalization, resulting in the refusal to allow a resident to return following evaluation and treatment at a psychiatric hospital. The resident in question was an elderly male with severe cognitive impairment, Alzheimer's disease, schizoaffective disorder, and a history of behavioral disturbances, including aggression and elopement risk. Documentation showed that the resident required moderate to total assistance with daily activities and had a care plan addressing his behavioral and safety needs. Progress notes detailed multiple incidents of aggressive and combative behavior by the resident towards staff and other residents, including physical altercations and attempts to elope. These behaviors led to the resident being transferred to a psychiatric hospital for further evaluation and treatment. While the resident was hospitalized, facility leadership, including corporate staff, decided not to permit the resident's return, citing concerns for the safety of other residents and staff. This decision was communicated to the ombudsman and the resident's family, and the resident's personal belongings were removed from his room, which was reassigned to another individual. The facility's own policy stated that residents should be permitted to return following hospitalization, and that not allowing a resident to return constitutes a discharge, requiring appropriate notice to the resident and their representative. However, the facility did not follow this policy, as the resident was not allowed to return and the required discharge procedures were not followed. Interviews with staff, family, and the ombudsman confirmed that the decision not to readmit the resident was made at the corporate level, and that the facility was aware this action could be considered an improper discharge or "dumping."