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F0628
D

Failure to Notify Ombudsman of Facility-Initiated Discharge

El Paso, Texas Survey Completed on 12-01-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide required notification to the Office of the State Long-Term Care Ombudsman regarding a facility-initiated discharge for a resident. Specifically, when the resident was given a written discharge notice due to non-payment for a private room, the facility did not send a copy of this notice to the local Ombudsman at the same time as it was provided to the resident. Although the discharge notice stated that a copy had been sent to the Ombudsman, interviews and record review confirmed that this was not done. The resident involved had a complex medical history, including generalized anxiety disorder, bipolar disorder, diabetes mellitus type 2, hypertension, congestive heart failure, and lupus. She was alert and oriented, with a BIMS score indicating cognitive intactness, and was admitted from home. The care plan noted her need for 24-hour licensed nursing care and a history of making false accusations, as well as a preference for a private room due to PTSD. The discharge was initiated after the resident was unable to pay for a private room and did not qualify for Medicaid. Interviews with the local Ombudsman and facility Administrator revealed discrepancies in the facility's documentation and communication. The Ombudsman was not aware of the discharge notice and had not received a copy, despite the facility's policy and the Administrator's initial claim that the notice had been sent. The Administrator later confirmed that the required notification to the Ombudsman had not been completed as per regulatory requirements.

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