HospitalInspections.org

Based on facility policy, medical record review and interview, the facility failed to ensure a timely discharge planning evaluation and failed to document the communication of the discharge plan to the patient/family for 2 of 3 (Patient #1 and 3) sampled patients.


The findings included:

1. Review of the facility "DISCHARGE PROCESS/STEPS" that was not dated revealed, " ...Please contact guardian or DCS [Department of Children's Services] at least 24-48 hours prior to the discharge date set by the MD [medical doctor] ..."

2. Medical record review for Patient #1 revealed a 14-year-old male involuntarily admitted to the adolescent acute psychiatric hospital on 12/1/2021 after a suicide attempt. Patient #1 had diagnoses of a recent suicide attempt and depression. Further review revealed the facility staff communicated with Patient #1's parent via telephone, on 12/3/2021 to complete the initial assessment and on 12/8/2021 to discuss the progress toward treatment plan goals. The case manager communicated with Patient #3's insurance company on 12/14/2021 that the anticipated discharge date was 12/17/2021. There was no documentation the facility communicated the planned discharge date to the parent.

Patient #1 was discharged home on 12/17/2021. The facility failed to implement adequate discharge planning to transition Patient #3 back home from his acute psychiatric hospitalization.

Medical record review for Patient #3 revealed a 12-year-old male admitted to the adolescent acute psychiatric hospital on 12/2/2021. Patient #3 was admitted from an emergency department in Franklin, Tennessee after a mobile crisis evaluation determined he was unsafe to return home. Patient #3 had diagnoses of psychosis, history of a recent suicide attempt and depressive disorder. Further review revealed the facility staff communicated with Patient #3's parent via telephone, on 12/3/2021 to complete the initial assessment and on 12/7/2021 to discuss the progress toward treatment plan goals. The case manager communicated with Patient #3's insurance company on 12/10/2021 that the anticipated discharge date was 12/13/2021. There was no documentation the facility communicated the planned discharge date to the parent.

In a telephone interview with Patient #3's parent on 1/10/2022 at 10:15 AM, the parent stated the facility did not communicate with her prior to 12/13/2021 when they called to inform her Patient #3 was being discharged the same day.

Patient #3's discharge date was delayed to 12/14/2021 due to the parent being unable make arrangements to pick the patient up on 12/13/2021. The facility failed to implement adequate discharge planning to transition Patient #3 back home from his acute psychiatric hospitalization.

3. In an interview on 1/11/2022 at 11:00 AM, the Director of Utilization Review and Case Management verified the facility staff failed to adequately document discharge planning for Patient #1 and #3.