Social services are required to be part of a facility-initiated discharge or transfer (see F-Tag 745) to help ensure resident needs are taken care of during a potentially difficult process. There are a limited number of conditions in which a skilled nursing facility may initiate a discharge or transfer. These are the 6 reasons for a resident discharge or transfer.
- The transfer / discharge is necessary for resident welfare and resident needs cannot be met in the facility.
- The transfer or discharge is appropriate because resident health has improved sufficiently so the resident no longer needs the services provided by this facility or by this facility’s distinct / non-distinct part.
- The safety of individuals in the facility is in danger due to the clinical or behavioral status of the resident.
- The health of residents in the facility would otherwise be endangered by this person.
- The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medi-Cal) a stay at the facility. If they became eligible for Medi-Cal after admission to the facility, the facility may only charge the resident’s allowable charges under Medi-Cal. Also, if the resident is admitted as a Medicare eligible resident the facility may charge them only allowable charges under Medicare.
- The facility is ceasing to operate.
There can be exceptions to this rule. For example, it is appropriate to transfer a resident in an emergency to an acute care hospital.
Ensuring that your facility is only initiating discharges and transfers in the appropriate circumstances is an important part of being an advocate for the rights and well-being of the residents in your care. Facilities need to understand that a resident who is difficult to manage is not eligible for a facility-initiated discharge unless he or she also falls in one of the six reasons.
For more information on the regulations, documentation, and processes around discharges, consider enrolling in “Social Services and Discharge Regulations” at SSD Training by Jody Giac.