OK, I'm going to play devil's advocate here, because I sit on the other side of that ALF administrator's desk, and there are two very good reasons why I insist on speaking to the discharge planner before a resident ever crosses the threshold after a hospital stay.
#1: If the resident has a need we cannot meet. There is a lot of confusion between ALFs, RCFs, and SNF/ICFs; in fact, these very different types of facilities are often lumped together by people outside community-based care, who tend to assume they all offer the same services. Not so! I'm the DON for a 42-bed ALF, and we don't deal with IVs or PICC lines, sterile dressing changes, new amputees, two-person transfers, acute psychiatric issues, or total feeds. Assisted living residents must be what's called "stable and predictable" before returning home; if they aren't, a nursing-home stay is a must.
#2: Hospitals often discharge people too sick, too quick. I can't count the number of times I've sent someone who was ambulatory and alert to the hospital for a short-stay procedure or with a touch of pneumonia, and gotten them back so confused, combative, or weak that we can't manage them. I know they have to go somewhere, but if we can't take care of them, they don't belong in the facility.
ALFs are sort of a halfway house---our residents are neither completely independent, like those who live in retirement communities, nor totally dependent like the majority of those residing in nursing homes. We don't have the staff nor the resources to care for the acutely ill; in fact, most don't even have a licensed nurse on duty 24/7. Now I don't know about anyone else, but I wouldn't want MY elderly parent going home to a facility where he or she would be checked on every 2 hours at best, and maybe once or twice per day at worst. Neither would I be able to sleep knowing he or she was alone in an apartment, too weak to get up to the bathroom without two aides to help (and they only staff one caregiver at night).
THAT'S why we sometimes get edgy about accepting residents back after hospitalization. It's one thing when someone is discharged to their own home in bad shape; quite another when "home" is a licensed facility providing care (within certain limits). We don't do it to be mean or to get out of taking back a resident we consider undesireable; we do it to protect the resident, and yes, to protect ourselves. Try not to be so quick to judge; we're all on the same team!