Long-term care facility leaves some discharge paperwork incomplete

The OIG recently released an audit of Mountain View Health & Rehabilitation, which focused on whether all requirements were followed when discharging patients. The long-term care facility is licensed to care for 187 patients, all protected from inappropriate discharges by state law.

The audit found that patients discharged during the audit's scope were not presented with written information about their rights to appeal any unwanted discharges or the contact information for the State Long-term Care Ombudsman. Additional resource information was not provided to patients with disabilities or mental illness. Failing to provide this information can worsen outcomes or result in complications for patients leaving the facility.  

Patients are released from a facility either at their request or if they meet specific standards related to facility safety, need for services or non-payment. Auditors also found that of the 75 reviewed discharges, Mountain View failed to provide documentation on why a discharge was initiated for 16 patients and could not provide records of a patient requesting to be discharged for 15 clients the facility claims asked to leave.

Auditors found that Mountain View had no defined procedure for collecting discharge information. Failure to provide this information can lead to patients being inappropriately discharged.

Of the 75 discharges reviewed by the OIG, 36 were initiated by the facility. Mountain View claimed none of these were financially related. However, they could not provide records from a physician detailing why 10 patients were discharged. This information is essential for continued patient care by other providers and for verifying that patients were not inappropriately released.

The OIG provided three recommendations to assist the facility in resolving noted issues with their discharge procedures. Specifically, Mountain View should:

• Ensure its discharge process includes providing appeal and advocacy information to residents
• Maintain documentation for what warranted the determination to discharge in the residents' clinical records.
• When it initiates a discharge for reasons other than non-payment or facility closure, ensure an appropriate physician documents the basis of the discharge.

If you or someone you know lives in a long-term care facility and needs assistance, contact the State Long-Term Care Ombudsman at 1-800-252-2412 or visit https://apps.hhs.texas.gov/news_info/ombudsman/ for additional information.