Reminder to Nursing Homes: New Requirements Apply to Facility-Initiated Transfers and Discharges
Nursing homes are reminded that state legislation enacted earlier this year requires facilities to take certain steps when transferring or discharging residents. Under the legislation, facilities are prohibited from initiating a discharge or transfer, except when necessary for the resident’s health, safety, or welfare or the health, safety, or welfare of other residents; when the facility is closing; or when the resident has failed to pay for his or her stay. Nursing homes may also transfer or discharge a resident because the resident does not need residential health care facility services or when the resident's transfer or discharge is initiated by the resident or his or her representative.
Specifically, prior to a facility-initiated transfer or discharge of a resident, the facility must exercise best efforts to secure appropriate placement or a residential arrangement for the resident, other than “temporary housing assistance” (e.g., other than a shelter or hotel). If a facility initiates a transfer or discharge to the home of another individual, it must secure the written consent of the resident and the other individual and ensure that the other individual has received and acknowledged the discharge plan. Unless certain conditions are met as outlined below, at least 30 days prior to a facility-initiated transfer or discharge, the nursing home must notify in writing the resident, the resident's representative, a family member of the resident, and the long term care ombudsman. The notification must state the basis for the transfer or discharge, which must be recorded in the resident's clinical record.
If the nursing home is unable to meet the needs of the resident, the resident may be transferred or discharged, and in that case, the facility should document in the resident’s clinical record (i) the specific need or needs that cannot be met; (ii) the facility's attempts to meet the resident's needs; and (iii) the services available at the receiving facility. When a resident is being transferred or discharged because the resident cannot be cared for safely, or is a danger to others, prior notice may be provided less than 30 days prior to the transfer or discharge, but must be provided as soon as practicable prior to transfer or discharge. The facility must document in the resident's clinical record the risks to the resident or others if the resident were to remain in the facility.
If the resident initiates a transfer or discharge, and the clinical record notes that a family member or designated representative has requested notification, and such notification is otherwise lawful, the residential health care facility must notify the family member or designated representative of the resident's voluntary transfer or discharge as soon as practicable and in no event more than 48 hours later. The notice must not be provided if the resident specifically requests that the family member or designated representative not be notified.
A nursing home must not attempt to compel an individual to voluntarily transfer or discharge from the facility. According to the legislation, every resident has the right to remain in care unless appropriately discharged or transferred. The facility is prohibited from retaliating against an individual who chooses to remain in care.
The Department of Health (DOH) has not issued any regulations, Dear Administrator Letter (DAL), or other guidance in relation to this legislation. We will notify members if we receive any further communications pertaining to these requirements.
Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838