Current through Bulletin 2024-06, March 15, 2024
(1) Each licensee shall develop written
admission, transfer, and discharge policies and make these policies available
to the public upon request.
(2) The
licensee shall permit each resident to remain in the facility, and not transfer
or discharge the resident from the facility unless:
(a) the transfer or discharge is necessary
for the resident's welfare and the resident's needs cannot be met in the
facility;
(b) the transfer or
discharge is appropriate because the resident's health has improved
sufficiently so the resident no longer needs the services provided by the
facility;
(c) the health or safety
of an individual in the facility is endangered;
(d) the resident has failed, after reasonable
and appropriate notice, to pay for a stay at the facility; or
(e) the licensee ceases to operate the
facility.
(3) The
licensee shall ensure resident transfers or discharges are documented under any
of the circumstances specified in Subsection
R432-150-22(1),
in the resident's medical record. The licensee shall ensure the transfer or
discharge documentation is made by:
(a) the
resident's physician if transfer or discharge is necessary under Subsections
R432-150-22(1)(a) and
(b); or
(b) a physician if transfer or discharge is
necessary under Subsection
R432-150-22(1)(c).
(4) Before the transfer or discharge of a
resident, the licensee shall ensure:
(a) a
written notification of the transfer or discharge and the reasons for the
transfer or discharge to the resident is provided in a language and manner the
resident understands, and, if known, to a family member or legal representative
of the resident;
(b) the reasons
are recorded in the resident's clinical record; and
(c) the notice includes the following:
(i) the reason for transfer or
discharge;
(ii) the effective date
of transfer or discharge;
(iii) the
location where the resident is transferred or discharged; and
(iv) the name, address, and telephone number
of the state and local long term care ombudsman programs.
(5)
(a) Except when specified in Subsection
R432-150-21(6)(a),
the licensee shall ensure the notice of transfer or discharge required under
Subsection R432-150-(21)(4), is made by the licensee at least 30 days before
the resident is transferred or discharged.
(b) The licensee may issue the notice of
transfer or discharge as soon as practicable before transfer or discharge if:
(i) the safety or health of individuals in
the facility would be endangered if the resident is not transferred or
discharged sooner;
(ii) the
resident's health improves sufficiently to allow a more immediate transfer or
discharge;
(iii) an immediate
transfer or discharge is required by the resident's urgent medical needs;
or
(iv) a resident has not resided
in the facility for 30 days.
(c) The licensee shall ensure that the notice
for nursing facility residents with developmental disabilities contains the
mailing address and telephone number of the Disability Law Center that is
responsible for the protection and advocacy of developmentally disabled
individuals; and
(d) The licensee
shall ensure that the notice for nursing facility residents who are mentally
ill contains the mailing address and telephone number of the Disability Law
Center who is responsible for the protection and advocacy of mentally ill
individuals established under the Protection and Advocacy for Mentally Ill
Individuals Act.
(6) The
licensee shall provide discharge planning to prepare and orient a resident to
ensure safe and orderly transfer or discharge from the facility.
(7) Before a licensee transfers a resident to
a hospital or allows a resident to go on therapeutic leave, the licensee shall
ensure:
(a) written notification and
information is provided to the resident and a family member or legal
representative that specifies:
(i) the
policies regarding bed-hold periods permitting a resident to return;
and
(ii) the duration of the
bed-hold policy, if any, and the resident is permitted to return and resume
residence in the facility;
(b) written notice is provided to the
resident and a family member or legal representative, that specifies the
duration of the bed-hold policy at the time of transfer of a resident to a
hospital or for therapeutic leave;
(c) notification is provided as soon as
possible following a transfer necessitated by a medical emergency;
and
(d) a written policy is
established and followed for when a resident whose hospitalization or
therapeutic leave exceeds the bed-hold period may be readmitted to the
facility.
(8) The
licensee shall establish and maintain identical policies and practices
regarding transfer, discharge, and the provision of services for each
individual regardless of pay source.
(9) The licensee shall have a written
transfer agreement in effect with one or more hospitals to ensure that:
(a) residents are transferred from the
facility to the hospital and ensured of timely admission to the hospital when
transfer is medically necessary as determined by the attending
physician;
(b) medical and other
information needed for care and treatment of residents is exchanged between
facilities including documentation of reasons for a less expensive setting;
and
(c) security and accountability
of personal property of the individual transferred is maintained.
