Failure to Provide Proper Discharge Notice and Planning
Penalty
Summary
The facility failed to provide a resident with proper notice prior to discharge, specifically omitting the address of the discharge location on the notice and not notifying the resident as soon as practicable before the discharge occurred. The resident, who was cognitively intact and had significant medical needs including vertebra osteomyelitis, stage 3 and 4 pressure ulcers, neuromuscular bladder dysfunction, paraplegia, protein-calorie malnutrition, cellulitis, and sepsis, was served with an immediate discharge notice due to alleged threats made toward staff and administration. The discharge notice did not include the required address of the discharge location, and the resident was not given adequate time or information to prepare for the discharge. Interviews and record reviews revealed that the resident was offered a hotel stay and transportation to a hospital, both of which he declined, but he was not provided with an alternative placement or a clear discharge plan. The resident reported having nowhere to go after discharge and ultimately slept in his truck, missing necessary wound care, ADL care, and meals. Staff interviews confirmed that the discharge planning review was incomplete, and there was no documentation of the alleged behavioral incidents leading to the discharge in the resident's progress notes or the facility's incident log. The resident's care plan indicated a high level of dependence on staff for daily care and medical management, yet these needs were not addressed in the discharge process. The facility also failed to document or communicate the location to which the resident was being discharged, as required by regulation. The discharge was executed in the presence of police officers, and the resident was served with a no trespass order. Despite the resident's request to appeal the discharge and remain in the facility during the appeal process, the facility did not allow him to stay, citing immediate jeopardy. The lack of proper notification and discharge planning resulted in the resident being left without a safe or appropriate discharge destination, and the facility did not ensure continuity of care or services post-discharge.