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Based on record reviews and interview, the facility failed to ensure the physician updated the discharge summary to indicate one of one patients (Patient #1) was documented as being discharged against medical advice.

Findings included:

Record review of Patient #1's Discharge Summary revealed Physician #1 originally completed the document on 10/19/15 1800 PM, but marked thru the 10/19/15 date as discharged on 11/06/15 at 1045 PM. Physician #1 did not document why Patient #1 was discharged from the facility against medical advice.

Continued review of Patient #1's medical record revealed a Progress Note, dated 11/06/15 at 1756 and completed by Registered Nurse #1, revealed Patient #1 was discharged against medical advice to the care of Patient's #1's father who was transporting her to a residential treatment center. No reason for the discharge against medical advice was documented in the progress note.

Interview on 08/18/16 at 1:00 PM with Patient #1's father revealed that he was contacted on 11/05/15 by the facility that Patient #1 was being discharged on 11/06/15. He stated he came to get her at 0700 on 11/06/15 to transport her to a residential treatment center in another city. He stated that she was officially discharged around 1300 PM. He was told by the nursing staff that she was being discharged against medical advise but he stated he was not given a reason as to why the facility discharged Patient #1 against medical advice.

Interview on 08/18/16 with the facility Director of Performance Improvement/Risk Management confirmed that Physician #1 did not update the Discharge Summary to indicate why Patient #1 was discharged against medical advice. She confirmed that Physician #1 was no longer working at the facility.