DAL NH 15-06: Transfer & Discharge Requirements for Nursing Homes

September 23, 2015

Subject: DAL NH 15-06 - Transfer & Discharge Requirements for Nursing Homes

Dear Administrator:

This letter is to remind providers of their responsibilities related to the transfer and discharge of nursing home residents in accordance with 42 CFR 483.12 and 10 NYCRR Section 415.3. These requirements apply to long term care services, as well as subacute care.

The Department's concern regarding provider trends related to resident transfer and discharge are below:

  • Failure to issue written "Notices of Transfer or Discharge" and/or cite the regulatory basis for the proposed transfer or discharge for long term and subacute residents.
  • Refusal to readmit nursing home residents who are temporarily hospitalized.

Prior to any transfer or discharge, a written "Notice of Transfer or Discharge" must be provided to the resident. This includes residents receiving long term care, as well as subacute care services. The Notice must include the regulatory basis for the transfer or discharge as specified in 10 NYCRR 415.3

In addition to the above, State and Federal regulations require that nursing home residents who are temporarily hospitalized be allowed to return to the facility following hospitalization, without regard to payment source, and with or without bed hold. In the absence of bed hold or in the case of expired bed hold, the resident must be admitted to the next available semi-private bed. Hospitals are not acceptable final discharge locations.

When sending residents with episodes of acting out behavior to hospitals for treatment, the nursing home is responsible to readmit the resident and/or develop an appropriate discharge plan. In these cases, the hospital is not considered to be the final discharge location. With imminent danger transfers, the facility is required to hold the bed for the resident.

If you have questions regarding transfer and discharge requirements, please call Ms. Mary Jane Vogel, Statewide Complaint Manager, Division of Nursing Homes and ICF/IID Surveillance at (518) 402-5447.

Sincerely,

Shelly Glock, Acting Director
Division of Nursing Homes ICF/IID Surveillance
Center for Health Care Provider Services and Oversight