Nursing Home Discharge
One of the greatest benefits that our life care planning clients receive protecting rights at a nursing home.
We have often encountered potential clients whose loved one was placed in a nursing home for rehabilitation. They tell us that the nursing home has instructed them that they will have to find an alternative placement for the patient when the Medicare days run out. Typically the nursing home tells the family that they have no “long term beds” into which to transfer the patient.
Our clients understand that such a discharge may violate Federal law. The law provides only five criteria for legal discharge. These criteria include:
- the patient’s health has improved such that the resident no longer needs the services provided by the facility
- the safety of other individuals is endangered
- the health of individuals in the facility would be otherwise endangered
- for non-payment after reasonable notice
- the facility ceases to operate.
We have found that the nursing homes usually do not actually discharge the patient in such scenarios. Instead they convince the family to “voluntarily” remove the patient. (Should the nursing home issue a “notice of discharge” immediate action must be taken to challenge the discharge). The nursing home has financial incentives to keep beds filled with Medicare patients as the nursing home reimbursement rate for Medicare is nearly three times that which it is for a Medicaid patient and twice that which they receive for a private pay patient. However, by Federal law, the nursing homes are prohibited from discharging due to a change in payment source. We strongly recommend that before a family acts at the urging of the nursing home to remove a resident, that the family seeks legal advice regarding such a move. A patient’s right to be in a facility are much easier to protect if the patient is currently placed in a nursing home compared to needing services outside the facility.
The Agency for Health Care Administration regularly reviews and rates long-term care facilities.