Failure to Provide Discharge Instructions in Resident's Preferred Language
Penalty
Summary
The facility failed to provide a resident with discharge instructions in their preferred language, Spanish, when the resident chose to leave the facility against medical advice (AMA). The resident, who had a history of alcoholic cirrhosis with ascites, protein calorie malnutrition, and alcohol dependence, was admitted with ongoing needs for long-term care. The Minimum Data Set indicated that the resident's preferred language was Spanish and that communication abilities were sometimes limited. On the day of discharge, the resident expressed a desire to leave after being placed on one-on-one supervision following an alleged incident of physical abuse with another resident. The resident informed staff of plans to go to a hotel, though no specific destination was provided. The resident had an active physician order allowing passes out of the facility for up to four hours. When the resident signed the AMA form, both registered nurses present were unable to communicate in Spanish or provide a translated version of the discharge instructions. Facility policies required that residents be informed of their rights and responsibilities and that discharge planning should address individual needs and preferences, including language. Despite these policies, the facility did not ensure the resident received information about the risks and benefits of leaving AMA in a language the resident could fully understand, resulting in the resident leaving without adequate comprehension of the implications.