Did you know that the residents of nursing homes have very specific rights regarding the facility’s ability to transfer or discharge them from the facility? There are six conditions that would justify the transfer or discharge of a resident from the facility. These include:
1. The resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility;
2. It is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility;
3. The health of individuals would otherwise be endangered;
4. The safety of individuals is endangered;
5. The resident has failed, after reasonable and appropriate notice, to pay; and/or
6. The facility ceases to operate.
The facility must have adequate documentation in the resident’s records to substantiate a transfer or discharge. Before transferring or discharging a resident, the facility must also provide written notice to the resident, and if known, to a family member or legal representative. This notice must be made at least 30 days before the discharge date. The notice must contain all of the following information:
a. The reason for the transfer or discharge and the effective date;
b. The location to where the resident is to be transferred
c. A statement that the resident has the right to appeal to the state;
d. The name, address and phone number of the state Licensing and Certification District office;
e. The name, address and phone number of the Long-Term Care Ombudsman;
f. A statement that the resident may represent him/herself or use legal counsel, a relative, friend or other spokesman;
g. A statement that the resident or resident’s representative must be allowed to review, prior to and during the appeal hearing, the resident’s medical records and the documents to be used by the state;
h. A statement that the resident may bring witnesses to the hearing;
i. A statement that the resident should file the appeal within 10 days so as not to jeopardize the ability of the state to make a ruling prior to the discharge date;
j. A statement that the facility may permit the resident to remain even if the state has not made a decision within 30 days; and
k. A statement that if the state upholds the discharge notice, that the resident should be prepared to be transferred.
The facility’s refusal to readmit a resident during a bed hold in an acute care hospital will be treated as an involuntary transfer, allowing the resident the right to appeal the transfer. If the resident is on Medi-Cal or has another source of payment, the resident can remain in the hospital until the final determination of the hearing officer. If the resident has no other source of payment, the hearing and determination must be made within 24 hours.
Note that a readmission after a bed hold is not a new admission, but a continued stay.
The resident has to have resided in the facility for at least thirty days before the above-mentioned 30-day notice is applicable. Regardless of how long a resident has resided in a facility, the facility must provide sufficient discharge planning to ensure that the resident is transferred to an appropriate alternative facility.
(Source: Code of Federal Regulations 483.12 (a); California Health & Safety Code §1599.1).
If you have questions about any of the information outlined above, please call the CANHR office at 1-800-474-1116.