TRANSFER and DISCHARGE

Can the nursing home force me to leave after I have been admitted, or transfer me against my wishes?

Federal and state law restricts the circumstances in which a nursing home can discharge a resident. Basically, the law provides that a nursing home may not discharge a resident without their cooperation unless the move is necessary for medical reasons, or is necessary for the welfare of the resident or other residents, or for non-payment of the resident’s bill. Unless a discharge is justified for one of these reasons, the nursing home may not discharge the resident. Under non-emergency circumstances, you are entitled to 30 days advance notice in case of a discharge or transfer.

Whether or not you can be transferred within the facility depends on the contract, and also whether or not medical needs are involved. Ask about the nursing home’s transfer policy.

If my medical condition requires that I be admitted to a hospital, will the nursing home give my room to someone else?

The conditions under which a resident may return to his or her accommodations at the nursing home after a temporary absence is called the “bed hold policy.” If you can afford to pay, the nursing home will usually hold your bed for your return. Medicaid will not pay the nursing home to hold the resident’s room. However, if the hospitalized Medicaid resident wishes to return to the nursing home, Medicaid rules require the nursing home to make the first available Medicaid bed available to the resident. 

What if I wish to leave the nursing home for several days to visit friends or family?

Leaving the nursing home to visit family or friends overnight is called “therapeutic leave.” Again, the nursing home’s bed hold policy determines what will happen to your accommodations. Remember, Medicaid does not pay to hold your bed while you are absent from the nursing home.


TRANSFER and DISCHARGE--WHEN and HOW:

When a transfer or discharge is based on one of the allowed criteria, the nursing home is required to follow certain procedures. In non-emergency situations, the nursing home is required to give written notice of the transfer or discharge. The nursing home must also assure that the transfer or discharge will not be made in less than 30 days from when the resident receives the notice. The resident is entitled to at least 30 days notice of a transfer or discharge.

The notice must also state the reason for the transfer or discharge, and it must state that the resident has the right to appeal the transfer or discharge decision. Appeals are made to the Department of Medical Assistance Services, Appeals Department. The right to such an appeal is available to every resident, whether they are private pay or on Medicaid.

See the section “WHERE TO GO for HELP” at the end of this article for information on whom to contact to appeal an adverse discharge by a nursing home.

WAIVERS

An important factor to consider in looking at a nursing home contract is the matter of contractual waivers of liability. A waiver in a nursing home contract is a paragraph that attempts to protect the nursing home from any legal responsibility for accidents, thefts, and/or other problems the resident might encounter while living in the nursing home. State and federal law does not address liability waivers for personal property, so this is largely a matter for negotiation between the nursing home and the resident.

What if something of mine gets lost, broken or stolen?

If the contract appears to contain a waiver for personal property or valuables, consider carefully what personal funds and property the resident will keep, and the responsibilities of the nursing home in handling or protecting such funds or property. Nursing home contracts frequently contain liability waivers absolving the home of some or all of the obligation to compensate the resident for lost or stolen property. Explain the resident’s situation to the nursing home representative, and get a full explanation of what will happen if something happens to the resident’s property or funds. Find out if any other resident has had a problem with this in the past.

What if I am injured? 

Sometimes, a nursing home might try to include a waiver in the contract relieving the nursing home of liability for personal injuries suffered by the resident in the nursing home. Although no specific state or federal law regulates this type of waiver, such a blanket waiver of liability for personal injury of residents is likely to be legally unenforceable, and would probably not protect a nursing facility from obligations to compensate an injured resident. Ask the nursing home representative to delete such a waiver from the contract before you sign it.

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