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Do I have to sign the discharge agreement?

Dear Advocate:

My sister was recently placed in a nursing home after surgery on her hip. The nursing home asked me to sign an agreement that my sister will be discharged when she no longer needs therapy services. I’m not sure if she will be ready to come home when her therapy is finished. Do I have to sign the agreement?

Stumped in Stockton

Dear Stumped in Stockton:

You do not have to sign the agreement for discharge at the termination of therapy services. More importantly, the proposed agreement is illegal. In order to be licensed, all nursing homes must provide long-term care services to its residents regardless of how long the services are needed. Therapy is only one of many long-term care services needed by nursing home residents. Kathleen Billingsley, the Deputy Director of the California Center for Health Care Quality, wrote that “the fact that a skilled nursing facility chooses to focus on [short-term therapy] does not allow the facility to ignore the state and federal limitations on grounds for transfer or discharge of a resident.” Thus, a facility may not seek to evict a resident simply because she no longer needs therapy. And, a facility may not ask a resident or her representative to sign an agreement to the contrary. Many nursing homes are seeking higher profits by focusing on therapy services for which they receive a large amount of money. In some facilities, residents who are not eligible for therapy are considered unprofitable and unwanted. The law prohibits such discrimination.

You have a couple of options for ending your visitation restriction. One is to inform the court that granted the conservatorship about what is happening. Another is to inform the nursing home that its visitation restriction is illegal and give it a copy of Judicial Council Form GC-341. If neither of those options work, call CANHR.