Thank you so much for all that input and information!! I did end up reaching out to the client yesterday afternoon with an interpreter through her insurance so I could give her all of those instructions for advocacy and crisis hotlines specific to her language and culture. Also left the conversation letting her know that we could continue services only if she were in a safe environment, that we would no longer go to her place of residence where this individual lives. 
Notified the MD today and they are fully aware and unfortunately have informed me they are well aware of all the issues and concerns for quite some time. 
I also did email the worker with the county that sent me all the resource information to let him know we were potentially discharging services. He thanked us for being good advocates, but didn't indicate any further action.
I think I have checked all the boxes, I just wish there were more we could do for her. Tentatively if she declines to get to a safe location for services, she is aware we will discharge by next week, but we plan to give her time to take action and advocate for herself and assist her with that in any way we can before we dc for cause. I'm hopeful this will motivate her to move in the right direction.
Thank you again, always nice to seek and get great input to ensure we are not only compliant but that we have taken all measures we possibly can.

On Tue, Aug 3, 2021 at 3:21 PM Brianna Lindell <blindell@mnhomecare.org> wrote:

Hi Jenifer,

 

The below answer has come from one of our Nurse Consultants:

 

In addition to the steps that you have already taken to help this patient, I recommend the following:

 

  • It doesn't sound like you are planning to send staff out to the home anymore, and I agree with that plan. The safety of your staff needs to come first.
  • Contact the patient by phone to inform her of the immediate termination plans (if that is your plan). Give the patient discharge instructions and safety instructions over the phone. I would also give her the phone numbers to any advocacy groups and remind her to call 911 for further issues.
  • I recommend letting Adult Protection know you are discharging for cause- so they can take that into consideration when determining whether to open the case or not.
  • The obvious- document all of the steps you have taken as well as the collaboration between your staff and leaders.

 

Would love to hear from others on this listserv for additions or comments :)

 

I hope that helps!

 

Brianna Lindell

Regulatory Affairs Manager

Minnesota Home Care Association

 

1265 Grey Fox Road, Suite 2 | Arden Hills, MN 55112-6929

Direct: 651.240.3380 | Main: 651.635.0607

www.mnhomecare.org | blindell@mnhomecare.org

 

 

 

From: comprehensivecompliance@list.mnhomecare.org <comprehensivecompliance@list.mnhomecare.org> On Behalf Of Jenifer Baker
Sent: Monday, August 2, 2021 11:07 AM
To: comprehensivecompliance@list.mnhomecare.org
Subject: Discharging for unsafe environments?

 

What is your process, or is there anything I might be missing if agency is wanting to discharge a patient for being unsafe? We have an individual where her husband is being violent and threatening towards the patient while staff are in the home. This has now occurred twice where I have called out police intervention. After the first time things were a lot better and he was not living there, or appeared not. But we just had a second incident today, and I am not comfortable with staff being in this position.

  • VA report already filed x2, with the county giving me a list of resources for the patient, which we have given to her, but they did not open nor said this would be a VA case. 
  • County case worker aware and notified
  • MD office aware and notified
  • patient has family she can stay with at another location, however she declines to remain with family because she says that her husband threatens to just come there and hurt her family if she doesn't come home
  • husband has a history of mental health issues
  • police today didn't arrest him, rather they drove him to a park and put the pt on the phone with an advocate for filing a restraining order

I'm concerned for staff being in these situations and today a staff person couldn't leave because he was blocking the entry/exit door. If she declines to be in a safe location, is there anything else I need to know prior to proceeding with a discharge? 

 

--

Jenifer Baker, OTR, PTA

Director of Rehabilitation

Firstat Nursing Services

Comprehensive Home Care and Therapy Services

2395 Ariel St. N, 
Suite A
Maplewood, MN  55109

Office: 651-288-0222 ext. 2003

Direct Number: 651-409-4378

Fax: 651-288-0214

 Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.

   

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--
Jenifer Baker, OTR, PTA
Director of Rehabilitation
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N, 
Suite A
Maplewood, MN  55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214

 Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.