Failure to Provide Behavioral Health Services for Community Re-Integration
Penalty
Summary
The deficiency involves the facility’s failure to provide necessary behavioral health services to support a resident’s goal of community re-integration. The resident was admitted with multiple serious behavioral health diagnoses, including Borderline Personality Disorder, Suicidal Ideation, Anxiety, Bipolar Disorder, Major Recurrent Depression, Post-Traumatic Stress Disorder, Cocaine Abuse, and Nicotine Dependence. The care plan documented that the resident was independent in meeting emotional, intellectual, physical, and social needs and usually able to perform ADLs independently or with supervision. The care plan also identified a goal for the resident to return home or to the community, with interventions that included evaluating whether independent or assisted living would be most appropriate, making arrangements with community support resources, and providing written instructions to the resident. Surveyors observed the resident on a locked unit designated for individuals with serious mental illness and behavioral health needs. During an interview, the resident expressed a belief that staff wanted to remove him from the facility and requested to speak with the Administrator for clarification. The DON indicated there were plans to discharge the resident to another facility and referred questions to the Social Services Director. The Social Services Director later stated that the resident was not being forced out but that the facility was not able to provide the types of group services needed to support the resident’s community re-integration goal. The Social Services Director explained that these needed services could be provided at another nursing facility and that referrals had been sent, with a discharge scheduled, demonstrating that the facility did not provide the behavioral health services necessary to meet the resident’s identified goal for community re-integration.
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