YOUR RESIDENT WENT TO THE HOSPITAL. CAN THEY AUTOMATICALLY COME BACK?
A resident falls, becomes ill, or experiences a change in condition and is sent to the hospital.
A few days later, the family calls:
“Mom is being discharged today. We’re bringing her back.”
Not so fast.
A hospital discharge does not automatically answer whether the resident is still appropriate for your assisted living facility.
THE ALF STILL HAS A RESPONSIBILITY
Under Rule 59A-36.006, F.A.C. — Admission Procedures, Appropriateness of Placement and Continued Residency Criteria, Florida establishes criteria for both admission and continued residency in an assisted living facility.
Florida Statute §429.26 also places responsibility on the owner or administrator for determining the continued appropriateness of a resident’s placement based on the resident’s needs, medical examination, services available or arranged, and the limitations of the facility’s license.
In other words:
“The hospital discharged them” does not necessarily mean “the ALF can safely meet their needs.”
FIND OUT WHAT CHANGED
Before the resident returns, find out what happened during the hospitalization.
Did their mobility change?
Do they now require significantly more assistance with activities of daily living?
Are there new medications or treatments?
Do they have new wounds or nursing needs?
Has their cognitive or behavioral condition changed?
Are there new orders the facility will need to follow?
The resident who left your facility three days ago may not be the same resident coming back.
REVIEW BEFORE YOU SAY YES
This doesn’t mean you should create unnecessary barriers to residents returning home.
It means you should know what you’re accepting.
Obtain and review the appropriate discharge and medical information. Determine whether the resident’s current needs can be met under your license and with the services available or arranged.
If something is unclear, communicate with the hospital, healthcare provider, family, home health, hospice, or other involved providers as appropriate.
Don’t wait until the resident arrives at the front door to discover:
“We can’t provide this level of care.”
HOW TO STAY COMPLIANT
Before a resident returns from the hospital:
- Determine what changed during the hospitalization.
- Review current medical and discharge information.
- Identify new medications, treatments, and care needs.
- Determine whether your facility can meet those needs.
- Arrange necessary outside services when permitted and appropriate.
- Make sure staff know about important changes before the resident returns.
- Document your review and communications.
THE BOTTOM LINE
A hospital may determine that the resident no longer needs hospital-level care.
That does not automatically determine whether the resident meets Florida ALF continued-residency requirements.
That is a determination the ALF cannot simply hand over to the hospital or the family.
Before you say:
“Bring them back.”
Ask:
WHAT CHANGED, AND CAN WE STILL SAFELY MEET THEIR NEEDS?
That simple question can prevent a much bigger compliance problem after the resident returns.
OFFICIAL RESOURCES
Rule 59A-36.006, F.A.C. — Admission Procedures, Appropriateness of Placement and Continued Residency Criteria
https://flrules.org/gateway/ruleno.asp?Section=0&id=59A-36.006
Florida Statute §429.26 — Appropriateness of Placements; Examinations of Residents