Tampa Nursing Home Cited for Violating Discharge Policies
Bristol at Tampa Rehab and Nursing Center LLC has been cited for failing to document a reason for discharge, failing to notify resident representatives with adequate time before transfer or discharge, and failing to create a plan that would meet residents’ needs for four residents.
One resident was a part of the Memory Unit in this facility and had been assessed as severely cognitively impaired. This resident had no active discharge plan to return to the community. The nursing home staff met to discuss the resident’s care plan, but family were documented as being unable to attend. The meeting notes showed that the resident needed no new referrals and that the staff present discussed the resident’s medications and care.
It is strange that in a meeting meant to help the resident that no referrals were discussed, when the facility had chosen to discharge this resident and had a responsibility to refer her to a new facility. This citation includes information relevant to the facility’s failure to follow state and federal regulations. This piece of information shows how the nursing home staff failed to create a plan for this resident, as is required when a resident is discharged into their family’s care or another facility.
The staff included no reason for the resident’s discharge. There was no care plan to go along with this change, which would allow the facility to document and track changes to the resident’s discharge process. No notes showed ways the facility was working to help the resident and her family prepare for this change in the resident’s life.
Additionally, there was no documentation that the family asked for their loved one to be transferred or notes describing the reasons for the resident’s discharge. This nursing home chose to discharge a resident who needed the services their facility could provide without a clear reason or a plan to ensure her safety once she left.
This citation clearly shows the failure of this facility to care for residents in accordance with state regulations. This resident was in a secure Memory Unit in the facility and had registered as severely cognitively impaired. The resident’s family had likely placed her in this facility because they knew they could not provide the round-the-clock care that a nursing home could provide for residents who are at risk of elopement, injury, or confusion in their everyday lives.
The nursing home staff did document that they talked with the resident’s son, telling him that his mother would be discharged. He gave them the name of the assisted living facility where she would be transferred and the name of the therapy service that would visit to take care of her. When this resident left, two staff assisted her to her son’s car and noted that she was alert and showed no signs of distress.
While the resident did not show signs of distress when leaving the facility, her file did show that she was showing signs of confusion. For nursing home residents with impaired memory, completing daily tasks and maintaining a high quality of life can be difficult without the proper care. Bristol at Tampa Rehab and Nursing Center created a situation in which a resident with severe cognitive impairment went to an assisted living facility, a location without the high standard of medical care that this resident needed to stay safe and live well in her final years.
The state surveyor who reviewed this issue spoke with the resident’s son after the fact. The son shared that he had received a call from the facility, notifying him that his mother would be discharged because the Memory Unit was being renovated and residents would no longer be safe. He was surprised and said he must have missed the mailing or written notice, but the facility told him the call was the only notice they were providing. The son was unhappy about this forced discharge, because his mother was happy and stable. Why would he want to move his mother to another home if she was doing well?
The facility provided the son with a “consultant” who helped him find another facility for his mother. This new facility was taking care of his mother well, and she seemed to take the adjustment well. Bristol at Tampa Rehab and Nursing Center, however, did nothing to assist in the transition, other than to have the consultant call him. He called Bristol at Tampa multiple times asking for more information and assistance, but never received a call back. Understandably, he was very disappointed in the facility’s actions.
It is a similar story for the other three residents in this citation. They were assessed as severely cognitively impaired and relied on the facility for their Memory Care Unit. There was no documentation in the residents’ files regarding a discharge reason or a care plan to assist the residents in their transfer to other facilities. The Administrator and Director of Nursing both confirmed that their nursing home had not specified the reasons for this change or fulfilled their responsibility to ensure a smooth, safe transition.
Both the Administrator and Director of Nursing confirmed that their reason for discharging residents was the renovation of the Memory Unit. They said that this made the facility less secure for residents who would need a secure unit. They also said that no care plan had been created for these four residents, given that they were long-term residents in the facility.
This information should make it all the more necessary to create a care plan for each resident and to clearly state the rationale for the discharge. These residents were there for a long-term stay and their families relied on the care they received in this facility. These residents are especially vulnerable due to their memory loss and cognitive impairment.
The facility failed to follow their own policy regarding discharge of a resident, which included creating a plan for residents, contacting future providers, transferring medical records, and notifying the residents’ representatives of the change in advance to allow them to appeal if needed.
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