Prevent Early Discharge Due to Bleeding Disorder-Related Concerns

HOW TO

While it is encouraging that some behavioral health facilities are beginning to accept individuals with bleeding disorders into their treatment programs, we are increasingly hearing reports of patients being discharged early—before completing their full course of treatment—due to concerns related to their bleeding disorder. Most commonly, facilities cite the cost of medication or discomfort with infusion/injection procedures as reasons for early discharge. These disruptions can have serious consequences for both the person’s medical stability and their recovery from mental health or substance use conditions.

This section of the provider toolkit focuses on how HTC and bleeding disorder providers can actively partner with behavioral health facilities after a patient has been admitted, to support safe, continuous care and prevent premature discharge. 

Recommendations for Partnering with the Facility After Your Patient Is Admitted

Once a person with a bleeding disorder is accepted into an inpatient or residential behavioral health program, the role of the HTC provider extends beyond securing admission—it becomes essential to support the facility in implementing the patient’s treatment plan and ensuring the individual is able to remain in care safely and without interruption.

HTC providers should take the following steps to partner effectively with the facility and advocate for their patient:

  • Provide the facility with clear documentation of the patient’s bleeding disorder treatment protocol, including dosing schedules, product instructions, and what to do in the event of a bleed or medical concern. MASAC Document 289 includes recommended language for inclusion in the emergency action plan.

  • Ensure the facility is prepared to:

    • Store bleeding disorder medication and supplies securely and, if necessary, in a climate-controlled or refrigerated space;

    • Provide a clean, semi-private location for infusions or injections (e.g., a medication room or nursing office);

    • Support the administration of medication according to the treatment plan.
      If any concerns arise, this toolkit includes guidance and support materials to help facilities implement these accommodations safely.

  • If the facility cannot procure the bleeding disorder medication:

    • Arrange for delivery through a specialty pharmacy;

    • Coordinate with a family caregiver to bring in pre-dispensed medication;

    • Set up support from a visiting nurse agency (VNA) if necessary.

    • A few days before the individual’s first scheduled infusion or injection, HTC providers should proactively contact the facility to review and confirm the medication plan. This check-in helps ensure:

    • The facility is comfortable with the process and expectations;

    • A clear plan is in place for who will administer the medication;

    • The medication and necessary supplies are onsite or en route; and

    • The facility is prepared to support the patient’s care without delay.

  • Remind the facility that, under the Americans with Disabilities Act (ADA), they are legally required to provide reasonable accommodations to ensure that individuals with disabilities—such as bleeding disorders—can access necessary medications while in treatment.

  • Regularly check in with the facility to address any new questions or concerns. Staying engaged helps prevent misunderstandings and reduces the risk of early discharge due to modifiable logistical or clinical issues.

This early communication can prevent confusion, reduce anxiety among facility staff, and ensure that the patient receives their treatment on time—reinforcing medical stability and supporting their ability to fully engage in behavioral health care.

Through early planning and active collaboration, HTC providers play a vital role in supporting successful treatment outcomes and ensuring that people with bleeding disorders receive uninterrupted behavioral health care.