Kirti Reddy and Theresa DeAngelis Write Article for Behavioral Health News on Issues Involving Nursing Homes Discharging Residents with Mental Health Disorders
Quarles & Brady attorneys Kirti Reddy and Theresa DeAngelis wrote an article for Behavioral Health News outlining issues involving nursing homes discharging residents with mental health disorders.
The article addresses the current federal regulations involving when a nursing home can initiate discharges of residents. Reddy and DeAngelis review the U.S. Department of Health and Human Services Office of the Inspector General (HHS OIG) reports that examine nursing home facility-initiated discharges of nursing home residents. In the reports, HHS OIG recognized that discharges that do not follow federal regulations can be unsafe and traumatic, potentially leading to resident harm.
The HHS OIG reports also identify risks to the people it serves, evaluates issues and provides reports of recommended necessary improvements.
An excerpt:
Nursing homes care for a growing number of adults with mental health disorders. In fact, mental health is sometimes a decisive factor that contributes to placement in a nursing home, causing nursing homes to become the de facto institution for persons with mental illness. Thus, there is increasing concern when nursing homes admit a resident with mental health disorders but then discharges that resident, often for allowable reasons, as that may impact the resident’s health and safety.
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In HHS OIG’s review, nursing homes most frequently initiated discharge because the resident’s behavior endangered the resident or others in the facility. “Endangering behavior” includes the safety of individuals in the facility being endangered due to the clinical or behavioral status of the resident, the health of the individuals in the facility being endangered, and the inability of the facility to meet the resident’s welfare and needs (e.g., the facility could not keep a resident safe from wandering, elopement, suicide or self-harm).1 Physical and/or verbal aggression was the most common endangering behavior observed.
After endangering behavior, failure to pay was the second most frequent reason for discharge. In 16 discharges, no reason was documented, though 6 had indications in the medication records that these discharges were due to endangering behaviors. Finally, improved health was the least frequent reason for discharge.