Failure to Provide Required Written Discharge Notice and Appeal Rights
Penalty
Summary
The facility failed to provide a written notice of discharge, including the reasons for the move and the right to appeal, to a resident and her representative at least 30 days prior to discharge. The resident, who had severe cognitive impairment and multiple medical diagnoses including hemiplegia, hemiparesis, dysphagia, and depression, was dependent on assistance for health literacy and functional cognition. Despite care plan requirements for communication and involvement in discharge planning, there was no documentation in the resident's progress notes or electronic health records indicating that a written discharge notice was given to the resident, her representative, or the Ombudsman. Interviews with facility staff revealed a lack of understanding and compliance with the regulatory requirement to provide a 30-day written discharge notice. The care manager (CM) and assistant director of nursing (ADON) both acknowledged that the notice was not provided, and the CM admitted to not knowing the requirement to notify the resident, representative, and Ombudsman in writing. The resident's representative reported learning about the discharge from a medical equipment provider rather than the facility and stated that neither she nor the resident received information about the right to appeal the discharge or the appeal process. Facility policy reviews confirmed the requirement for a 30-day written notice of discharge, including information on the reason for discharge, effective date, location, contact information for the Ombudsman, state survey agency, appeal rights, and resources for assistance. The policy also specified that the Ombudsman must be notified before discharge is initiated. Despite these policies, the facility did not provide the required notifications or documentation, resulting in a deficiency related to discharge planning and resident rights.