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32 | OS1 disclosed R1’s wound dressing must have been changed at some point prior to their evaluation by the ER Physician, no bleeding or wound issues were observed, and pictures were secured and provided to the Department. At approximately 6:30 AM, hospital staff informed OS1 that R1 was ready for discharge and that facility staff confirmed they would readmit R1. R1 was transported by ambulance back to the facility, with OS1 following. Upon arrival, staff informed OS1 that the COO had directed them not to allow R1 back into the facility or their room. R1 and OS1 remained outside. OS1 contacted Hospice, who stated the facility could not refuse R1’s return. Hospice attempted to contact the COO. Staff attempted to connect with the COO by phone; however, OS1 overheard the COO decline to speak. Emergency medical personnel then spoke with the COO for several minutes. After this communication, EMT staff informed OS1 that R1 would need to return to the hospital. EMT personnel stated this decision was made by the COO and the facility owner and confirmed they were unable to compel the facility to accept R1. R1 was transported back to the hospital.
During an interview, the COO stated that when R1 returned to the facility, staff communicated concerns regarding whether the facility could continue meeting R1’s care needs. The COO reported instructing staff not to readmit R1 until the COO had an opportunity to reassess whether R1 could remain safely at the facility. Because their reassessment had not yet been completed.
An additional interview conducted with Outside Source 3 (OS3) disclosed they informed the COO that the facility could not refuse R1’s return and that Licensing would be contacted if R1 was denied readmission. OS3 reported advising the COO that a facility must readmit a resident after being released from a hospital or ER stay, unless a qualified professional has documented that the resident requires relocation or a higher level of care and the Department was notified, which had not been provided. While at the emergency room, OS1 received a call from R1’s Hospice agency indicating the facility reported that R1 required a higher level of care and could not return to the facility. OS3 also revealed speaking with Outside Source 4 (OS4) who corroborated the facility being in violation for not allowing R1 back into the facility/their room. [see LIC 811 for confidential name list].
Based on interviews, documentation reviewed, and corroborating statements, the allegation that the facility refused to re-admit R1 and failed to follow required procedures regarding resident acceptance, as well as violation of personal rights were determined to be substantiated. An exit interview was conducted with Jabul Gozales and a copy of the report and appeal rights were provided.
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