December 12, 2009
Letters to the Editor
On behalf of the more than 400 volunteer long-term care ombudsmen statewide who advocate for improved quality of life and care for residents, I am sharing a concern about a growing trend in Florida's nursing homes -- the improper transfer or discharge of residents. Proper resident transfer and discharge processes are crucial to protecting the safety and ensuring the well-being of elders in nursing homes.
When a nursing home initiates the transfer or discharge of a resident who has lived there at least 30 days, the staff must provide the resident with a written 30-day notice, unless certain conditions exist.
Under state and federal law, a resident may only be discharged for one of six specified reasons, including falling behind in payment, endangering him/herself or others or if the facility is unable to provide adequate care for the resident's needs.
Both endangerment and a facility's inability to care for the resident must be documented in the resident's medical record. This documentation for discharge may only be completed by the facility's medical director or the resident's physician. If this authorization occurs, the resident and legal representative must then be given proper notice of the facility's intent.
If the resident falls behind on payments, the nursing home has the duty to assist the resident in enrolling in the appropriate Medicaid or Medicare Programs to cover the costs. If a resident is still behind in payment after assistance is provided, then the facility may discharge the individual with 30-day notice.
A copy of all discharge notices must be sent to the local long-term care ombudsman office. This gives ombudsmen the opportunity to review cases and facilitate any communication necessary between a resident and the facility, ensuring each resident receives treatment and respect and the right to challenge an improper transfer or discharge is protected.
Residents should never be threatened with a transfer or discharge by any staff member. Any such threats are a violation of federal and state law and should be reported to the ombudsman and/or to the Agency for Health Care Administration.
All residents have the right to file a request for a fair hearing to appeal a discharge. If a residents believe they have grounds to appeal, the Long-Term Care Ombudsman Program encourages them to file a request for hearing within the first 10 days of receiving notice. This allows a resident to remain in the current facility until the hearing is over. An ombudsman volunteer can assist in the hearing process as well as represent residents at the hearing.
If you or a loved one has concerns about a transfer or discharge notice, or any other issues concerning a long-term care facility resident, call us toll-free at 1-888-831-0404 or visit us online at http://ombudsman.myflorida.com.
Brian Lee, State Ombudsman, Department of Elder Affairs, Tallahassee