| 3 |
WASHINGTON CTR FOR AGING SVCS |
95014 |
2601 18TH STREET NE |
WASHINGTON |
DC |
20018 |
2018-07-20 |
660 |
D |
1 |
0 |
2ROW11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on record review and staff interviews, for one (1) of three (3) residents, it was determined that facility staff failed to ensure a safe discharge for Resident #1. The findings include: Resident #1 was admitted to the facility on (MONTH) 3, (YEAR). According to the admission Minimum Data Set (MDS) assessment with a target date of (MONTH) 18, (YEAR), Resident #1 scored 15/15 on the Brief Interview for Mental Status in Section C (Cognitive Patterns). According to the MDS 3.0 User's Manual page C-14, a score of 13-15 suggests that the resident is cognitively intact. Resident #1 was assessed as requiring extensive assistance with bed mobility, transfers, dressing, and personal hygiene and totally dependent for toilet use and bathing in Section G (Functional Status). Disease [DIAGNOSES REDACTED]. On (MONTH) 13, (YEAR), Resident #1 received a notice of Medicare non-coverage effective (MONTH) 15, (YEAR). Employee #1 petitioned the (Medicare management company) for a discharge on (MONTH) 18, (YEAR), to allow the facility to arrange for a safe discharge with appropriate home care. The (Medicare management company) agreed to a discharge date of (MONTH) 18, (YEAR). Employee #1 explained the situation to Resident #1 on (MONTH) 14, (YEAR). According to Employee #1's progress note dated (MONTH) 14, (YEAR): .met with resident and responsible party. Advised resident and family members of Medicare non-coverage and right to appeal the decision through independent medical review. Resident declined appeal .Resident advised and agrees to discharge on 6/18/18 . According to Employee #1's progress note dated (MONTH) 18, (YEAR): Resident is discharged to the care of his/her family. Discharge planning conference held on this date with all disciplines present. (Medicare Management Company) contacted for case management. . Referral was sent to Delmarva by Employee #1 on (MONTH) 14, (YEAR) requesting evaluation for home care services. Delmarva and the (Medicare management company) approved Resident #1 for home care. Resident #1 had previously been discharged from the facility on (MONTH) 10, (YEAR) and all necessary durable medical equipment was in place. A telephone interview was conducted with the (Medicare management company) on (MONTH) 23, (YEAR) at 10:15 AM. The Medical review supervisor stated that Employee #1 (at the nursing facility) was notified on (MONTH) 20, (YEAR) that Resident #1 had been approved for home care services and a referral from the facility physician was all that the (Medicare management company) needed to initiate home care services. There was no evidence that Employee #1 had followed-up with the home care services agency. On (MONTH) 20, (YEAR), two (2) days after the discharge, the complainant contacted Employee #1 to notify him/her that homecare services had not yet started. The complainant requested information to be sent to two (2) other home care agencies. Information was faxed to the additional one (1) of the home care agencies by Employee #1 the same day. There was no working fax for the other home care agency. There was no evidence that Employee #1 had followed-up with the home care services agency. Through interview conducted on (MONTH) 27, (YEAR) at 10:30 AM, Employee #1 acknowledged that he/she failed to follow up with Delmarva and (Medicare Management Company) to ensure that home care services were scheduled for Resident #1. Employee #1 stated in an interview conducted on (MONTH) 27, (YEAR) at 10:30 AM that he/she thought since services had previously been received in the home, and that this was a simple resumption of care not requiring a referral. Employee #1 acknowledged that he/she failed to follow up with Delmarva and the (Medicare management company) regarding the home care agencies chosen by the family to ensure that Resident #1 received home care services. The record was reviewed (MONTH) 18, (YEAR). |
2020-09-01 |