Failure to Permit Return of Residents After Hospitalization or Therapeutic Leave
Penalty
Summary
The facility failed to establish a valid basis for discharge for two residents who were not permitted to return after hospitalization or therapeutic leave, contrary to facility policy and regulatory requirements. For the first resident, who had chronic conditions including COPD, stroke, and polyneuropathy, the facility issued a 30-day discharge notice for non-payment, which was appealed and overturned by the state. Despite this, after the resident was hospitalized for respiratory distress, internal communications revealed the facility decided not to readmit the resident due to financial reasons, even though the resident's care needs had not changed and the discharge assessment indicated an anticipated return. For the second resident, who had diabetes, a right below-knee amputation, and COPD, and was cognitively intact and independent with an electric wheelchair, the facility failed to allow return after a therapeutic leave. The resident had planned to return after the leave but was directed by the DON to be evaluated in the ER due to a fall and skin breakdown. After ER evaluation, the facility informed the hospital that the resident would need to be reviewed as a new admission and could not return until the next day, despite no significant change in care needs being documented. Interviews with facility staff confirmed that the first resident was denied readmission due to financial issues, not changes in care needs, and that the second resident was not permitted to return after ER evaluation, with staff expressing uncertainty about the rationale. Facility policy required residents to be permitted to return after hospitalization or therapeutic leave unless their needs had changed and could not be met, which was not followed in these cases.