Procedural Requirements for Involuntary Transfer or Discharge

Jeannine LeCompte, Compliance Research Specialist

Involuntary transfers and discharges from skilled nursing facilities must follow a strictly defined set of guidelines, no matter if initiated by the facility or the resident.

Before a facility transfers or discharges a resident, the facility must:

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.
Record the reasons for the transfer or discharge in the resident’s medical record and include all physician notes, diagnoses, and other documentation demonstrating the need for the transfer.

The notice of transfer or discharge must be made by the facility at least 30 days before the resident is transferred or discharged, with the only exception being in the case of a serious criminal event or immediate danger to other residents.

In such cases, notice must be made as soon as practicable before transfer or discharge when:

The safety of individuals in the facility would be endangered;
The health of individuals in the facility would be endangered;
The resident’s health improves sufficiently to allow a more immediate transfer or discharge;
An immediate transfer or discharge is required by the resident’s urgent medical needs; or
When a resident has not resided in the facility for 30 days.

The written notice must include the following:

The reason for transfer or discharge;
The effective date of transfer or discharge;
The location to which the resident is transferred or discharged;
A statement of the resident’s appeal rights, including the name, address (mailing and email), and telephone number of the entity which receives such requests; and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request;
The name, address (mailing and email), and telephone number of the Office of the State Long-Term Care Ombudsman;
For nursing facility residents with intellectual and developmental disabilities or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with developmental disabilities established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000;
For nursing facility residents with a mental disorder or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act.

If the information in the notice changes prior to effecting the transfer or discharge, the facility must inform the recipients of the notice as soon as practicable once the updated information becomes available.

In the event of the closure of a facility, the administrator must also provide written notification prior to the impending closure to the State Survey Agency, the Office of the State Long-Term Care Ombudsman, residents of the facility, and the resident representatives, as well as the plan for the transfer and adequate relocation of the residents.