Failure to Readmit Resident Despite Bed Availability
Penalty
Summary
A deficiency occurred when a resident with diagnoses including liver cirrhosis, COPD, and bipolar disorder was transferred to a general acute care hospital (GACH) for altered mental status. The resident was cleared for return to the facility by the hospital, but the facility repeatedly denied readmission, citing a lack of available male beds. However, facility records indicated that a male bed was available on several dates during the period in question. The facility's Admission Director (AD) acknowledged receiving multiple inquiries from the hospital's discharge planner regarding bed availability and confirmed that the resident was denied readmission by the Administrator (ADM) without a clear reason. The Director of Nursing (DON) stated that the facility could meet the resident's needs and that there was no justification for denying readmission, even after the expiration of the seven-day bed hold period. The resident remained in the hospital for 14 days beyond the initial discharge date due to the facility's refusal to readmit. A review of facility policies indicated that residents previously admitted to the facility should be readmitted when eligible, and that Medi-Cal/Medicaid eligible residents should be readmitted to their previous room or the first available bed in a semi-private room if hospitalized for more than seven days. Despite these policies and available beds, the facility did not readmit the resident, resulting in a prolonged hospital stay.