Resident Improperly Discharged due to Medicaid Funds Ending, Left at CSB for 9 Hours

Hughes Center for Exceptional children was cited by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) for deficiencies related to the improper discharge of a resident. Specifically, the DBHDS found that the facility was non-compliant with state regulations related to human rights, services and treatment, and discharge planning. DBHDS found that the provider:
“Neglected to provide, or arrange for…identified needs when Provider staff left [a] Resident in Chesapeake [at the Chesapeake Community Services Board] without ensuring the resident’s services were in place. This constitutes neglect.”
DBHDS noted that the  “Provider indicates discharge from program was due to Medicaid funding ending and the guardian not paying for the individual’s continued treatment at this facility.” On the day of discharge, facility staff took the resident to the Chesapeake Community Services Board (CSB) for intake and she stayed there from 9:30 am  to 6:30 pm while the CSB located another placement for her. DBHDS found:
“The provider failed to assure a successful transition of individual from a residential treatment center to another program or community, when they dropped her off at Chesapeake CSB without adequate supports in place for continued treatment or services.”
DBHDS also found that the provider’s discharge policies and procedures did not indicate how the provider would ensure appropriate discharge planning with reasonable supports in place for parental placements. The facility permitted this manner of discharge even though the resident’s treatment plan indicated she struggled to manage the negative symptoms of her diagnosis and needed multiple supports upon discharge, including: “structured, supported, therapeutic housing, continued medication management, ongoing individual and group therapy, social skills assistance, continued educational services for support towards her diploma options, continued remediation in math and reading skills, transitional readiness, independent living skills and vocational readiness.” Additionally, DBHDS found that the provider failed to follow regulations that state “residents shall be discharged only to the legal guardian or legally authorized representative.” According to DBHDS, “no documented evidence was found to indicate the legal guardians gave written permission for facility staff to transport the resident to a new placement.” In the Corrective Action Plan, the facility agreed to ensure that a written discharge plan is completed prior to discharge and provided to the individual and/or their guardian. Also, the facility agreed to update their policies to address appropriate discharge planning and have submitted the changes to the Facility Quality Council for approval. Lastly, the facility agreed not to transport a resident to the next placement if written permission is not received prior to the scheduled discharge date and time.