Failure to Permit Resident Return After Hospitalization
Penalty
Summary
The facility failed to permit a resident to return after a hospitalization, despite the resident being clinically stable and ready for discharge from the hospital. The resident, who had a diagnosis of malignant neoplasm of the lung and demonstrated intact cognition, was initially admitted to the facility and later transferred to an acute care hospital. Upon stabilization and readiness for discharge, the hospital attempted to coordinate the resident's return, but the facility refused readmission, citing concerns about the responsiveness of the resident's chosen physician. There was no discharge summary signed by the resident's physician, nor was there a physician order to discharge the resident from the facility. Communication records show that the facility administrator informed the ombudsman that the resident would not be allowed to return due to issues with the resident's physician, specifically a lack of responsiveness to urgent messages. The ombudsman clarified that the facility was responsible for ensuring physician coverage at all times and that a backup physician should be available if the primary physician was unavailable. Despite this, the facility did not respond to the ombudsman's request for clarification and did not issue a formal notice of discharge to the resident or their family. The resident's family member, who acted as power of attorney, was not notified by the facility about the refusal to readmit and only learned of it through the hospital's case manager. Interviews with the ombudsman and the facility administrator confirmed that the resident was not given an opportunity to select a different physician prior to the refusal of readmission. The administrator acknowledged that the facility did not notify the resident or family of the discharge and communicated only with the ombudsman. The resident's family attempted to appeal the discharge, but the facility maintained its refusal to readmit the resident during the appeal process. The facility's actions resulted in a delayed hospital discharge and emotional distress for the resident, who remained under the care of the same physician throughout the incident.