Best of my recollection...HHA can't see pt on day of discharge-not billable, we always saw pt next day to do intake/admit. HHA can see and eval pt prior to discharge so to have everything in place. No patient should ever be discharged without instructions, and a pt is not transferred to HHA, they are discharged and HHA is providing some services to them, pt/family will need to give meds, transfer to toilet..whatever it takes. Nurse can set up med box and perhaps they qualify for an aide to bathe a couple times a week, but incontinence etc falls to the family caregiver--Hospice can provide some heavier care, but 24/7 care is self pay or back to the LTC.
Your charting was litigation fuel or at the least State survey ammo. Perhaps something along the lines of ..Pt returned for clarification of home regime, meds,wound care. Husband present, instructed and return demo given with good understanding verbalized. In a separate narrative or even a variance report I would of listed the rest of it. And verify when HHA will see a patient before thay are discharged so the family will not be frantic or confused.
You should not have been fired for this, you should have been counselled unless your charting has been questioned before. You could fight this, I am sure you have a mediation/greivance process in place at your facility, do not ask for your job back, instead ask to have your dismissal listed as voluntary and 2-4 weeks pay, since you should have been warned or placed on probation and that would have been 30 days. You don't need a lawyer for that, but if they are not providing you with some satisfaction by all means call one, and let them know that is your plan.
When applying for the new job, personal differences is acceptable as a reason. Don't give any administrative people as ref, and ask your charge nurse or house supervisor if they will give you a personal ref.