Section 325.20116. Involuntary transfers.

(1) A patient shall not be involuntarily transferred or discharged, except as provided by section 21773 of the code and these rules.

(2)   For purposes of section 21773 of the code, all of the following provisions apply:

(a)   "Welfare of nursing home employees" means the physical safety of nursing home employees.

(b)    The 21-day notice period shall begin on the day the patient or patient's guardian actually receives the written notice.

(c)      The home shall maintain a record of efforts to collect payment where nonpayment is the basis for involuntary transfer or discharge and shall be capable of documenting the nonpayment and efforts to collect payment upon request by the department.

(d)   The written summary of the discussion required by section 21773(8) of the code shall be available to each person participating in  the discussion at the time it is made part of the patient's clinical record.

(e)   The home and the department shall assure that the counseling mandated in section 21773(9) of the code is provided.

(f)     The department shall monitor counseling of patients who are involuntarily transferred or discharged utilizing appropriate members of the department staff. These same members of the department staff, as part of the monitoring activity, shall be responsible for approving a facility plan to effectuate the orderly and safe transfer or discharge of a patient.

(g)    It shall be the objective of a transfer or discharge plan to assure all of the following:

(i)    That the proposed new placement is appropriate for the patient's needs and considers the recommendations of the attending physician.

(ii)   That the optimum placement is made, insofar as possible, the first time to avoid the necessity for additional transfers at a later date.

(iii)    That the patient or the next of kin, guardian, designated representative, agency, or organization responsible  for  placing  and maintaining the patient in  a facility is involved in the choice of facility to which the patient is to be transferred.

(iv)   That at least 1 counseling session shall be provided for each involuntarily transferred or discharged patient.

(v)   That the patient shall have the opportunity to visit the  proposed new placement at least once. The visit to the new site may only be waived if the attending physician documents in the patient's clinical record that such a visit is medically contraindicated or if the patient, guardian, or patient representative determines, in writing,  that  it  is   not in the patient's best interest. In such instances, the patient shall receive appropriate information, such as floor plans, brochures, pictures, and other  documents,   to familiarize the patient with the new facility.

(vi)      That the department assures that a family member or other appropriate person is available  to  accompany   the  patient  on  the involuntary transfer or discharge from the home to a new placement, unless the patient requests otherwise.

(h)   That the department assures that counseling in the new placement is provided following transfer or discharge and that counseling occurs within 72 hours following the transfer or discharge.

(3)   For purposes of section 21774 of the code,  both   of  the  following provisions apply:

(a)    Submission of a hearing request form shall be prerequisite to  a patient's appeal of an involuntary transfer or discharge, and any written communication from the patient or the patient's representative   to  the department shall be accepted as a request for a hearing on the matter if the department has reason to believe  the   communication is intended to dispute the proposed transfer or discharge.

(b)   Hearings shall be conducted informally by a representative of  the department at the facility in which the patient is located. The patient and home, or their representative, may state their position and present documents and other proofs at the hearing. Following the hearing, the department shall issue its decision and reasons therefor in writing, which decision shall be final and not subject to further administrative appeal.

(4)    This rule shall not   apply   when    a   facility    discontinues,   or   is required to discontinue, operations.

History:  1981 AACS.