Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency
It is important for a facility to review changes to the Requirements of Participation with all staff, including their Social Service Team. One area the Final Rule requires is that before a facility transfers or discharges a resident, the facility must notify the resident and the resident’s representative of the transfer or discharge in writing, including the reasons for the move.
The new regulation requires the facility to send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman.
The discharge notice is a phase one implementation and the effective date is November 28, 2016.
[Phase 1] (c) Transfer and discharge— (3) Notice before transfer. Before a facility transfers or discharges a resident, the facility must— (i) Notify the resident and the resident’s representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand. The facility must send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman
This also refers unplanned hospital discharges and whether this notice is required in these situations. CMS addresses this under the section which relates to the timing of the notice as follows:
- Notice must be made as soon as practicable before transfer or discharge when
- An immediate transfer or discharge is required by the resident's urgent medical needs, under paragraph (b)(1)(ii)(A) of this section;
“We consulted with the Administration for Community Living in the development of this proposal and believe that sending these notices to the State Long-Term Care Ombudsman will provide added protection to the resident and assist the State Long-Term Care Ombudsman to keep informed of facility activities.”
Additionally, the regulations governing the timing of this notice specifically reference those situations in which “[a]n immediate transfer or discharge is required by the resident’s urgent medical needs,” thereby including unplanned hospital transfers/discharges in the new notice requirements.
The Final Rule, therefore, seems to require that facilities provide prior written notice to the resident, resident representative, and LTC Ombudsman of all transfers and discharges, whether involuntary or voluntary, planned or unplanned.
This is certain to place a significant burden on facility social worker’s/discharge planners, as well as inundate State LTC Ombudsman Offices with information pertaining to planned, voluntary discharges. While placing significant emphasis on discharge planning and resident choice throughout the Final Rule, CMS simultaneously seems incredulous of the fact that most planned discharges and transfers are voluntary and consistent with the resident’s goals and wishes.”
Harmony Healthcare International (HHI) is available to provide ongoing education and training regarding transfers and discharges. If you need assistance, please contact us by clicking here or calling our office at (800) 530-4413.