Failure to Allow Resident to Remain During Discharge Appeal
Penalty
Summary
The facility failed to ensure that a resident who was appealing a discharge was allowed to remain in or return to the facility pending the outcome of the appeal. The resident, who had end stage renal disease requiring dialysis, a recent transmetatarsal amputation, and other diabetic ulcers, was given a 30-day discharge notice due to lack of an active payer. Despite submitting an appeal of the discharge, the resident was sent to the hospital and was not readmitted to the facility while the appeal was active. Documentation showed that the resident and family were actively seeking to resolve Medicaid issues and had requested a hearing to appeal the discharge. The family expressed that they were unable to care for the resident at home due to the resident's complex medical needs and lack of accessibility. The facility administrator confirmed that the resident was not allowed to return to the facility during the appeal process and could not provide evidence that the resident's right to remain or return pending the appeal was honored.