Failure to Provide Required Discharge Notice and Notification
Penalty
Summary
A deficiency occurred when the facility failed to provide required notice as soon as practicable before the transfer or discharge of a resident. The resident, a female with a history of cerebral infarction, muscle weakness, lack of coordination, type 2 diabetes with hyperglycemia, morbid obesity, and functional quadriplegia, was admitted to the facility and later found to be non-compliant with the facility's non-smoking policy. Documentation showed that the resident was informed on the same day that she had to transfer or discharge, without evidence of advance written notice or notification to the ombudsman as required. Progress notes and interviews revealed that the resident was found with a vape and other smoking materials, and was told by the social worker that she could either transfer to another facility that allowed smoking or be discharged home. The resident was given a very short timeframe—reportedly as little as 30 minutes—to make a decision about her discharge destination. The facility's staff, including the social worker and admissions coordinator, confirmed that the resident was told she had to leave that day due to violation of the non-smoking policy, and arrangements were made for her to go to a hotel with home health services set up. There was no documentation in the clinical record of a formal discharge notice or notification to the ombudsman. The facility's own transfer and discharge policy requires sufficient preparation and orientation to ensure a safe and orderly transfer or discharge, but the records and interviews indicate that the resident was not given adequate notice or options, and the process was expedited due to the policy violation. The administrator and staff interviews further confirmed that the discharge was prompted by the resident's non-compliance with the non-smoking policy and that the required notifications and documentation were not completed.