Failure to Inform Resident of Right to Leave Against Medical Advice
Penalty
Summary
The facility failed to ensure that a resident was informed of and allowed to exercise their right to leave Against Medical Advice (AMA). According to the facility's policy, a Discharge Against Medical Advice form must be completed when a cognitively intact resident or their legal representative insists on leaving AMA, and the attending physician, CEO, and DON must be notified. In this case, a resident admitted with anoxic brain damage was assessed as alert and oriented to person and place, but with some confusion, and was identified as a high elopement risk. The resident expressed a desire to leave, was observed crying and demanding to leave, and was placed on 1:1 supervision for safety. Despite these events, the resident left the facility AMA without signing the required AMA documents or receiving the mandated education about their rights and the AMA process. Interviews with staff revealed that the assigned nurse briefly mentioned the AMA process but did not review the AMA documents with the resident. The supervisor nurse also did not ensure the resident was informed of their rights or completed the necessary documentation. The DON and Administrator confirmed that the resident was not properly informed of their right to leave AMA and did not receive the required education, as stipulated by facility policy. This deficiency was identified for one out of five residents reviewed.