April 18, 2005

Discharging without Placement Plans Results in Forced Readmission

In a recent case, Paschall v. DC Department of Health (April 7, 2005), The District of Columbia Court of Appeals held that residents discharged from a nursing facility without a description of the resident's new location, could force the facility to readmit them.

What happened?

Samuel Paschall was a handful and difficult to deal with. He was monitored closely from the date of his arrival.

Some time after his admission, Paschall was discharged to a hospital due to complaints of abdominal pain and the nursing facility used his absence to issue an "Advance Notice of Discharge."

The notice lacked two federal law requirements for such discharge notices: facility must usually give 30 days advance notice, and facility must include a description of the location to which the patient will be discharged.

The facility quickly filled the vacancy. The attorney for Mr. Paschall asked the court to require that Paschall be readmitted to the facility as soon as Medicaid beds became available.

The court ruled that the Administrative Law judge could, after a finding that Paschall still wished to reside at the facility, force the facility to readmit him per Paschall's request. Paschall, however, would still have to establish that his return to the facility would not endanger himself or others.

What does this mean for nursing facilities?

The significant holding in this case was that the Administrative Law Judge has the authority to readmit an improperly discharged patient. In this case, the court found that the facility's failure to comply with the 30-day discharge notice made it impossible for the court to timely hear the case and have the opportunity to stay the discharge. The court found it unreasonable to deny Administrative Law Judge the power to restore the status quo ante (Paschall's residence at the home).