Complaint Investigation Report

The complaint alleges C1 was ready for discharge from a health facility and facility staff did not pick up C1 until hours later. Record review revealed that C1 moved into the facility on 11/20/2023. Interview and record review revealed that for about a month, C1 was engaging in unwanted behaviors and required medication adjustments. C1 was taken on a 5150 hold on 12/14/2023 at approximately 08:00AM. Interview revealed that C1's family was considering alternate placement at a higher level of care and had requested the facility staff not pick C1 up right away. At that time, they set up a meeting for C1's family, mental health team, and the facility staff to determine the appropriate plan for C1 going forward. Following discussion with the team, it was decided that C1 could return to the home. Documents reviewed revealed C1 was ready for discharge on 12/17/2023, however, no time of contact was listed on the discharge documents. Administrator could not recall the time a telephone call was received and stated the only delay was related to the family's request. Facility notes reviewed revealed that C1 returned to the home at some point between 11:00PM on 12/17/2023 and 06:00AM on 12/18/2023. Interview with C1 revealed facility staff do pick up when needed and C1 always receives prompt attention and pick up when requested. The information obtained during the investigation did not include sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of today's report was provided.