| Course | MSW 528 Medical Social Work I |
|---|---|
| Week | 7 |
| Paper type | Safe discharge case analysis |
| Length | About 600 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Social Work (MSW) |
| Updated | October 2026 |
Free sample paper for MSW 528 Week 7
Safe Discharge Case Analysis of H.'s Return Home After the Rehabilitation Appeal Failed: Three Conditions Tested One at a Time, Who Refused What and Could, the Record of Offers and Why Unwanted Is Not Unsafe
Student Name
Chamberlain University
MSW 528: Medical Social Work I
Instructor Name
Month Day, Year
Safe Discharge Case Analysis of H.'s Return Home After the Rehabilitation Appeal Failed: Three Conditions Tested One at a Time, Who Refused What and Could, the Record of Offers and Why Unwanted Is Not Unsafe
The Facts, Briefly
The plan upheld its denial on October 10. The team offered a skilled nursing facility bed. H. refused it twice and asked to go home. H. went home on October 13 with home health, a tub bench, a second stair rail installed by K. on October 12 and K. staying for three nights. Several team members called it an unsafe discharge.
The Standard
This analysis treats a discharge as safe if three conditions are met: the destination is available and has agreed; the patient's needs can be met there with the services arranged; and the patient, if capable, has decided with knowledge of the alternatives. The hospital's discharge planning obligations frame the first two (Condition of Participation: Discharge Planning, 2024).
Condition 1: An Available Destination
Met. The destination was H.'s own apartment. The second rail was in place, checked in a photo K. sent on October 12.
Condition 2: Needs Met There
Partly met, and this is the condition that gave way. Home health physical and occupational therapy began October 14. K. stayed three nights. Weekday mornings after October 16 had no one present, and H. still needed standby help on stairs. H. agreed to stay upstairs on weekday mornings until the therapist cleared H. for stairs alone, and to wear a medical alert button K. purchased. That lowers the risk without removing it.
Condition 3: A Capable, Informed Decision
Met. The attending neurologist assessed decision-making capacity on October 11 against the four abilities commonly used to judge capacity (Appelbaum, 2007). H. explained the facts back in H.'s own words, said the fall risk applied to H. and not just to people in general, compared the facility with home and gave the same answer on two days. H. said the facility "would kill my spirit" and chose to accept the risk with the rail, the button and the morning rule.
Who Refused, and What They Could Refuse
H. refused the facility, which a capable adult may do. The plan refused rehabilitation, which it could do subject to appeal, and the appeal was lost. Neither refusal was the team's to override.
The Record of Offers
October 8: rehabilitation requested. October 10: denial upheld; facility offered. October 10 and 11: facility refused. October 11: home with services offered and accepted. Each offer and response is documented with date and time.
Unsafe Is Not the Same as Unwanted
The team disliked the discharge because H. faced more risk at home than in a facility. That makes it unwanted by the team, not unsafe by the standard. A capable adult may choose more risk.
Calling this discharge unsafe would also have consequences for H. A label of unsafe in the chart can follow a patient into later admissions and color how teams respond to H.'s choices. Being precise about the word protects the patient's standing as a capable adult.
What the File Would Show a Stranger
A stranger reading the chart would find the denial, the appeal, two offers, two refusals, a capacity note and a services list. That record is what makes this discharge defensible to anyone.
References
Appelbaum, P. S. (2007). Assessment of patients' competence to consent to treatment. New England Journal of Medicine, 357(18), 1834-1840. https://doi.org/10.1056/NEJMcp074045
Condition of Participation: Discharge Planning, 42 C.F.R. ยง 482.43 (2024).
Reading the MSW 528 Week 7 instructions
The safe discharge analysis is organized around conditions rather than a run of days. Keep the case facts brief. State the standard you are using for a safe discharge before applying it. Take each condition in turn with evidence that it was or was not met, and give the most space to the one that gave way. Set out who refused what and whether they had the authority to refuse it. Include the record of offers with dates, since it is what makes a discharge defensible. Distinguish unsafe from unwanted. Close with what the file would show a stranger. If the case ended with the patient leaving against advice, apply the same conditions.
How the MSW 528 Week 7 example is put together
The facts section summarizes the upheld denial, two refusals of a facility bed and discharge home with home health, a second rail and three nights of family support. The standard section names three conditions and ties two to Condition of Participation: Discharge Planning (2024). The first condition is met by H.'s own apartment and the rail. The second is partly met, with weekday mornings uncovered and reduced by a stay-upstairs rule and an alert button. The third is met through a capacity assessment against the four abilities in Appelbaum (2007). Sections cover who could refuse what, a dated record of offers, the difference between unwanted and unsafe and what a stranger reading the chart would find.
MSW 528 Week 7 rubric: what full points look like
Calling a discharge unsafe with no stated standard is the first and largest loss, because the finding then rests on how the case made the writer feel. Close behind is treating unsafe and undesirable as the same word. Faculty credit a standard stated in advance, conditions tested one at a time, a capacity determination based on named abilities and a record of offers. Who could refuse what should be explained. Giving most space to the condition that gave way shows judgment. Sources on discharge obligations and capacity, cited in APA, support the analysis. A recommendation is optional, but the finding must follow from the conditions. Faculty also look for whether the paper treats the team's discomfort as data rather than as a verdict.
MSW 528 Week 7 help: mistakes that cost points
The analysis most often fails by declaring a discharge unsafe because the team was uncomfortable. Another common gap is skipping capacity, so a patient's refusal looks like noncompliance. Some papers narrate day by day and never state a standard. Others omit the record of offers, which is what protects both patient and hospital. If your case ended with the patient leaving against advice, test the same three conditions and record what was offered before the patient left. An analysis that holds up for your case will let a stranger see from the file why the decision was made.
Get a MSW-528 Week 7 example written to your instructions
Send the Week 7 instructions with the case your section published and any analysis framework it names, and a custom analysis written to them comes back inside 24 to 48 hours, free the first time. If the assignment also wants the documentation the case would have generated, that arrives alongside the paper.
More MSW 528 papers and MSW samples
- MSW 528 Week 1: Tow Lot Task Post
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- MSW 528 Week 3: Stroke Unit Rounds Write-Up
- MSW 528 Week 4: Stroke Discharge Plan Draft
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- MSW 528 Week 6: Rehabilitation Denial Appeal Letter
- MSW 528 Week 8: Hospital Practice Reflection
- MSW 529 Week 7: Care Management Plan
- MSW 526 Week 7: Self-Care Email Critique
- MSW 525 Week 7: Progress Review at Session 8
- MSW 524 Week 7: Intake Office Environment Review
MSW 528 Week 7 questions, answered
Can the patient be the reason the plan failed?
Yes, and analyses that refuse to say so lose marks in the same way as analyses blaming him for everything. A man who declines a facility and goes home to an empty apartment has made a decision the law protects. Record it as a decision, say what was offered and understood at the time, and let the analysis examine what the building did with his answer.
What if the case ends with the patient leaving against medical advice?
Then the analysis narrows usefully, because the questions become what was explained, what was offered before he went, whether anybody assessed his understanding, and what was arranged for somebody who was leaving regardless. Sections mark hardest on the assumption that a departure of that kind ends the obligation. It does not, and the paper that says so and shows what still happened scores well.
Does the analysis have to recommend something?
Most versions ask for a few closing lines, and the ones that earn anything stay inside the reach of a single desk. A recommendation about national coverage policy is true and unusable. A recommendation naming a call that could have been made on the Monday, by a worker with the caseload this worker had, is checkable and is what the closing section is for.
Where can I find a free MSW 528 Week 7 sample paper?
This page shows a complete MSW 528 Week 7 safe discharge analysis of a stroke patient's return home, with margin notes on each condition.
Why does the MSW 528 Week 7 sample call the discharge safe?
Because the destination was available, needs were partly met with added safeguards and a capable patient chose home after being offered alternatives, which makes it unwanted by the team rather than unsafe.