Resident Transfer and Discharge Requirements
With the implementation of MDS 3.0 the discharge planning process for residents was recharged and clarified effectively in Section Q. The increased volume of communication systems for long term care discharges have been challenged as well.. Recently however new questions have been raised for the purpose of resident protection afforded to residents going through the involuntary transfer or discharge process in the nursing home. To ensure compliance with the involuntary transfer or discharge a review of the regulatory specifics may assist you. The highlight specifics of the federal requirements for transfer and discharge in the nursing home are included but are not limited to this blog:
F201 42 CFR §483.12(a)(2) Transfer and Discharge Requirements defines resident welfare, unable to meet needs, resident health has improved, or safety or welfare of others would be endangered, resident fails to pay or facility ceases to operate.
F203 42 CFR §483.12(a)(4) Notice before Transfer details notification requirements, reasons recorded in the clinical record and completion of the items and timing as required of the facility. The facility must provide the resident and /or legal decision-maker with written notice when a decision has been made to involuntarily discharge the resident from the facility at least 30 days before the resident is transferred or discharged. The notice may be made as soon as practicable when specific criteria are met including: endangerment, health improvement, urgent medical needs present or resident resided in facility for less than 30 days.
42 CFR §483.12(a)(6) Specifics for the Content of the notice must include: the reason, date, location to which the resident is transferred or discharged; statement of right to appeal the action to the State, name, address and telephone number of the State long term care ombudsman or DD Part C contact, and the resident right to appeal the discharge decision must be made by the facility.
It would be recommended that a search of additional State specific criteria be reviewed to assure both Federal and State compliance. At minimum the State requirements include the facility providing the resident or legal representative with contact information such as a long-term care Ombudsman or advocacy organization as possible before issuing the notice to assist the resident in resolving any issue that led up to the discharge decision.
