Oh my!!! This sounds like a very serious legal issue. I also work at a large urban facility and we often have residents who leave on a whim. We consider them AWOL and, for MDS, complete a discharge tracking form as discharge return NOT anticipated. Many of them show back up in a day or so, maybe sooner. We then start over with an admission assessment. My thinking is, when they are AWOL they are often engaging in unhealthy behaviors so a comprehensive assessment is warranted. Also, I do not want the resident who leaves AMA to still be considered a resident of my facility when they are out there doing unhealthy behaviors. If they are capable of leaving and living on their own, do they really have a SNF need? So a new admission decision needs to be made when they choose to return. In your situation, though, if have been granted an LOA, that muddies the waters. We are not to do a discharge tracking form for LOAs. If the resident has been granted an LOA, then no discharge tracking form should be done until it is clear that the resident is not returning. If they are stating on exit from the facility that they are not returning, then it should not be considered a LOA. Hope your facility has a good lawyer.
-----Original Message-----
From: [EMAIL PROTECTED]
Sent: Nov 30, 2003 10:27 PM
To: [EMAIL PROTECTED]
Subject: LOA and survey
I am also in Ohio and our survey just ended. Much improvement over last year and we did really well with care and safety. I just want to let others know that they originally showed up en masse at 3 pm on a Monday. And they stayed 5 days. Fairly exhaustive survey. I believe that when the final report comes back, we will have done well, with just a few minor things. The only area of concern that I have (and my co-workers) is the issue of LOA's and bedhold days becoming a problem. Our facilty is urban and we have a lot of younger people with medical/psychological problems who all want the privilege of coming and going as they see fit. The DON was so afraid of census dropping, because these people would threaten AMA if we didn't give them the LOA that she overroad our own policy and would let them go. Many of them had let the staff know they had no intentions of returning and this would get charted. So MDS discharges them. But the admissions office kept them on the LOA list for up to thirty days and those days were often billed for. Fraud is fraud and no one would listen to the MDS nurses on this issue. And the DON is acting like this is the first she has heard of it. It is so frustrating and most of us don't know what to do. Our DON will do anything to cover her own behind, including dumping off on others. Because this is a serious issue, how do we handle it? From MDS point of view? Anyone else ever run in to this problem?
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-----Original Message-----
From: [EMAIL PROTECTED]
Sent: Nov 30, 2003 10:27 PM
To: [EMAIL PROTECTED]
Subject: LOA and survey
