Dear Administrator - Transfer and Discharge Rights

December 19, 2006

DQS/DAL # 06-23

Subject: Transfer and Discharge Rights

Dear Administrator:

The purpose of this letter is to remind you of your obligation under Federal (42CFR 483.12) and State (Title 10 NYCRR 415.3) regulation to provide transfer and discharge rights to all of your residents. This includes those residents who have no Medicaid bed hold due to the fact of being a resident of the facility for less than 30 days.

Whether or not there is a bed hold for a resident, in general the operator must provide a notice of transfer prior to any transfer, as well as a notice of discharge prior to any discharge. Any notice of transfer or discharge must:

  1. notify the resident and designated representative of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand.
  2. record the reasons on the resident's clinical record; and
  3. include in the notice the following items:
    1. for transfers or discharges a statement that the resident has the right to appeal the action to the State Department of Health and shall provide a phone number for the Department which can be used to initiate an appeal;
    2. the name, address and telephone number of the State long-term care ombudsman;
    3. for residents who are mentally ill or who have developmental disabilities, the mailing address and telephone number of the Commission on Quality of Care and Advocacy for Persons with Disabilities which is responsible for the protection and advocacy of such individual;
    4. a statement that, if the resident appeals the transfer or discharge to the Department of Health within 15 days of being notified of such transfer or discharge, the resident may remain in the facility pending an appeal determination. This clause shall not apply to transfers or discharges in one of the following situation:
      1. the safety of individuals in the facility would be endangered;
      2. the health of individuals in the facility would be endangered;
      3. the resident's health improved sufficiently to allow a more immediate transfer or discharge;
      4. an immediate transfer or discharge as required by the resident's urgent medical need; or
      5. the transfer or discharge is being made in compliance with a request by the resident.

Please make certain that all appropriate staff in your facility are aware of their responsibilities pertaining to each resident's transfer and discharge rights and the importance of honoring those rights.

Thank you in advance for your attention to this topic and your efforts to assure compliance.


Keith W. Servis, Director
Division of Quality & Surveillance for Nursing Homes and ICFs/MR