Health inspection·September 24, 2024

F 0626 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to follow appropriate discharge protocols for one of one resident (Resident 1). This failure had the potential for Resident 1 not being able to return to the facility which he considered his home and not being able to appeal the discharge. Finding: During a review of the admission Record, Resident 1 was admitted to the facility on [DATE] with a diagnosis of End Stage Renal Disease (irreversible kidney failure). During a review of the Bed Hold Agreement dated September 10, 2024. The Bed Hold agreement indicated that the facility will hold Resident 1 ' s bed for up to seven (7) days if the resident is transferred to a general acute care hospital The document indicated that Resident 1 was being transferred to [name] Hospital. During a review of the facility census, it indicated Resident 1 had a bedhold for September 10, 11, 12, 13, 14, 15 and 16. Per the same facility census, on September 17, 18, 19 it indicated Resident 1 was no longer on the census and was listed as being discharged . During a phone interview on September 26, 2024, at 14:25 P.M., with the complainant who was the case manager at [name] hospital. The complainant stated Resident 1 was ready to be discharge on [DATE] and had a discharge order. The complainant further stated she called the facility DON and the DON refused to take Resident 1 back and said Resident 1 had been discharged . During a phone interview on September 24, 2024, at 15:02 P.M., with Resident 1. Resident 1 stated, They say I am not welcome there, but that ' s like my home, my stuff is still there. How am I going to get that? During an interview on September 24, 2024, at 10:07 A.M., with DON. The DON stated Resident 1 was on a seven-day bed hold then discharged because the facility cannot meet his needs. The DON also stated that Resident was non-compliant with medications and diet, often refusing medications and ordering meals from outside of the facility. There were no evidence of documentation that Resident 1 was provided a 30 day notice and how to appeal. There were no evidence of documentation that the facility did a proper discharge for Resident 1. During a review of facility policy and procedure titled, Transfer and Discharge; Operational Manual- Social Services Revision date October 2017, the policy indicates, A . the Facility should provide Page 1 of 2 555878 555878 09/24/2024 Granite Hills Healthcare & Wellness Centre, LLC 1340 E Madison Ave El Cajon, CA 92021

F 0626 at least 30 days ' notice before the resident is transferred or discharged . Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 555878 Page 2 of 2