“’Gravely disabled’ patient left to fend for himself,” that is the charge filed in a civil enforcement action against Scripps Health in San Diego. The patient was diagnosed with schizophrenia and suffered from hallucinations, making it impossible for him to care for himself. He was hospitalized, delusional, refusing to attend to his basic needs, agitated, frequently cursing, etc. and the hospital discharged the resident to a group home, sounds logical right? 

Apparently not. When a case worker performed a wellness check on the patient, he was found to have not showered, was not taking his prescribed medications (adding to his behaviors) and his bed linens were soiled. Horrific conditions, sad story but wait, here comes a “secure skilled nursing center” taking on the challenge of providing care for this patient. Remember, there are no mental health resources available in most parts of the country. The report goes on to say that “his medical needs are being addressed in a safe and clean setting”. 

Not to be a Debbie downer, but most skilled nursing centers are not equipped to manage residents with severe schizophrenic behaviors. I’m hopeful that the center who accepted the admission can continue to care for him safely, but it is something for everyone to think about when reviewing referrals. Be absolutely sure that you can provide the care needed, don’t just focus on the cost of providing care, not that it isn’t important, but what cost is accepting an admission and not being able to provide the needed care. Think about it, talk to your nursing team and social worker if you aren’t sure, do an on-site visit (shocking but referral sources are not always honest), be sure you are doing the right thing for the right reasons! Stay the course, stay well, and stay informed!