Failure to Readmit Hospitalized Resident Despite Bed Hold Policy
Penalty
Summary
The facility failed to permit a hospitalized resident to return, contrary to its own bed hold policy and without documented evidence that it could not meet the resident’s care needs. The facility’s undated Bed Hold Policy stated that the Medical Assistance Program would pay the facility to hold a resident’s bed during a hospital stay or therapeutic leave and that a bed must be available when the resident returns. The resident, who had chronic respiratory failure, morbid obesity, and type 2 diabetes mellitus, was admitted to the facility on an unspecified date and later reported not feeling well, requesting a full medical workup at the hospital. In response, the facility arranged for transfer to the hospital of the resident’s choice, and the resident was admitted there. According to the hospital case manager, the resident was later medically cleared for discharge, and the hospital contacted the facility regarding readmission. The case manager reported that the facility refused to readmit the resident, stating they were not able to meet the resident’s care needs. Review of the resident’s clinical record showed no documentation supporting that the facility was unable to meet those needs. In an interview, the Administrator and the DON confirmed that the facility did not allow the resident to return after hospitalization.
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