Failure to Involve Resident in Choice of Destination During Involuntary Discharge
Penalty
Summary
The deficiency involves the facility’s failure to allow a cognitively intact resident to participate in choosing the destination facility during an involuntary discharge. The resident, who had paraplegia and multiple other medical conditions including moderate protein-calorie malnutrition, thoracic spinal cord injury, opioid dependence, neuromuscular bladder dysfunction, chronic pain, traumatic brain injury, neurogenic bowel, and a history of UTI, was issued an involuntary/emergency discharge with a receiving facility in another state already identified by the facility. The resident reported that he had lived in Kentucky before residing in Illinois, wanted to return to Kentucky, and was not asked where he wanted to go or offered any options in Kentucky. The resident stated he occasionally yelled at staff because they did not do what they were supposed to do and that he had spoken with the Ombudsman and the DON about his concerns. The Administrator stated that referrals were sent to multiple facilities and that one facility accepted the resident, after which the resident became upset about not being able to choose his destination or return to Kentucky. The Ombudsman reported that the resident had clearly expressed a desire to return to Kentucky and that this was communicated to the Administrator, who responded dismissively, and that the facility did not send referrals to facilities in Kentucky or allow the resident to participate in his own discharge. The Director of Admissions confirmed that he took over the discharge because the Administrator and Social Service Director no longer wanted to deal with the resident, that the resident was not permitted to suggest facilities, and that the involuntary discharge was issued with an accepting facility already identified by the facility. Facility policy required orientation and preparation of residents for facility-initiated discharges, and the Ombudsman pamphlet documented residents’ rights to participate in their own care planning, but the resident was not involved in selecting the discharge destination.
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