Admission, Transfer, and Discharge Requirements Flashcards

Under 42 CFR 483.15, how far in advance must a nursing facility generally give written notice before a facility-initiated transfer or discharge?

Answer: 30 days

The regulation requires written notice at least 30 days before transfer or discharge. Notice may be given 'as soon as practicable' only in specific exceptions, such as endangered health or safety, urgent medical needs, or a resident who has lived in the facility for less than 30 days.

Besides the resident and the resident representative, who must receive a copy of a facility-initiated transfer or discharge notice?

Answer: The Office of the State Long-Term Care Ombudsman

Section 483.15(c)(3)(i) requires the facility to send a copy of the notice to the Office of the State LTC Ombudsman. The Ombudsman can then help residents facing discharges that may be inappropriate.

Which of the following is NOT a permissible basis for a facility-initiated discharge under federal LTC requirements?

Answer: The resident's family frequently files grievances about care

The regulation lists six allowable reasons: needs cannot be met, health has improved, the safety of others is endangered, the health of others is endangered, nonpayment after notice, and facility closure. Discharging a resident because the family files grievances is retaliation and is prohibited.

A resident appeals a facility-initiated discharge. While the appeal is pending, the facility generally:

Answer: May not discharge the resident unless failure to discharge would endanger the health or safety of the resident or others

Under 483.15(c)(1)(ii), a facility may not transfer or discharge a resident while an appeal is pending, unless failure to do so would endanger the health or safety of the resident or other individuals. The facility must document that danger.

As a condition of admission, a nursing facility may NOT:

Answer: Require a third-party guarantee of payment

Section 483.15(a)(3) prohibits requiring a third-party guarantee of payment as a condition of admission, expedited admission, or continued stay. Someone with legal access to the resident's income or resources may be asked to pay from those funds without incurring personal liability.

When must a facility give a resident written information about its bed-hold policy?

Answer: Both well in advance of any transfer and again at the time of transfer

Section 483.15(d) requires bed-hold notice twice: in advance of a transfer (such as at admission) and again at the time of transfer, or within 24 hours in an emergency. The notice must cover the bed-hold duration, payment, and return policies.