Failure to Readmit Resident After Hospitalization
Penalty
Summary
The facility failed to readmit a resident following a discharge to a General Acute Care Hospital (GACH), despite the resident being ready for discharge from the hospital and the facility's own policies supporting the right to readmission. The resident, who had diagnoses including epilepsy and muscle weakness and was assessed as severely impaired in thought process and requiring maximal assistance with activities of daily living, was admitted to the facility in September and discharged to the hospital in December. When the hospital determined the resident was ready for discharge, the facility's Social Service Worker, Administrator, and Director of Nursing all communicated that the resident would not be accepted back, even though the facility's policies required readmission after hospitalization and there was no indication that the resident was ineligible for return. Interviews with facility staff confirmed that the decision not to readmit the resident was made by the Administrator and DON, and that the facility was equipped to care for the resident. The facility's policies, reviewed with the DON, explicitly stated the right to readmission after hospitalization, regardless of payment source, and did not provide any justification for denying the resident's return. The resident was ultimately readmitted several days later, but the delay constituted a violation of the resident's right to readmission as outlined in facility policy.