Is a nursing home’s policy of repeatedly discharging residents without providing for a safe, orderly transfer or discharge when Medicare coverage runs out a violation of a residents’ rights that could lead to the submission of a false claims in violation of the False Claims Act? F622 Transfer and Discharge Requirements; F623 Notice Requirements Before Transfer/Discharge; F624 Preparation for Safe/Orderly Transfer/Discharge
Compliance Perspective – Unsafe Discharge of Patients
Policies/Procedures: The Compliance and Ethics Officer, DON and Administrator will review the policies and procedures for the facility’s Admission, Transfer and Discharge protocol for residents to ensure they are providing safe, orderly transfer or discharge of residents in accordance with residents’ rights.
Training: Staff will receive training regarding the policies and procedures for an appropriate discharge and the process that must be followed.
Audit: An audit will be conducted periodically to review all discharges, the status of the residents’ Medicare coverage, and if the business office staff appropriately assisted residents with the process for seeking financial assistance from Medicaid or other potential sources. Audits will be summarized and submitted to the QAPI/QAA Committee and the Compliance Committee.
The state of Maryland recently reported reaching a settlement of $2.2 million in the lawsuit filed against the owners of a large nursing home company. The lawsuit was filed against the company for discharging residents unsafely when their Medicare coverage ran out and they were unable to pay for their care.
The company operated five nursing homes in the state, but according to a complaint filed with the lawsuit, 67 percent of the involuntary patient discharges throughout the state between January 2015 and May 2016, were from those five nursing homes. There were 225 other nursing homes operating in the state during that time.
It was reported that several of the discharged residents were “left at the doorsteps of unlicensed assisted living homes, and it was alleged that they were assaulted and robbed.”
The Attorney General argued that the company violated provisions for receiving Medicaid by discharging residents in unfair or unsafe ways. Medicaid does not allow a nursing home to accept payments for some residents while improperly discharging other residents.
The nursing home company is no longer allowed to operate in the state of Maryland.
