In November 2016, The Centers for Medicare & Medicaid Services (CMS) enacted their revised nursing home regulations. The standards dictate which nursing homes are eligible to receive Medicare & Medicaid funding. Failure to follow the regulations set forth by CMS could ultimately result in termination of federal funding. It is vital that residents and their loved ones are informed of the revisions in order to keep nursing homes accountable for their actions and to protect themselves. Below are some of the updates that have been made to regulations surrounding transferring and discharging a resident against their wishes, known formally as involuntary transfer and discharge.
Revisions Not Drastic but A Definite Improvement
According to CMS, the new requirements state 6 specific reasons that justify an involuntary transfer or discharge:
- The facility cannot meet the resident’s needs
- The resident no longer needs nursing facility services
- The resident’s presence endangers the safety of others in the facility
- The resident’s presence endangers the health of others in the facility
- The resident has failed to pay
- The facility is closing
While the changes to these 6 standards are not drastic, there is some promise of better resident treatment. One of of the most important changes is to rule #5, discharging or transferring a resident while waiting for a judgment on payment. If an appeal is pending with Medicare/Medicaid or another entity, the facility must keep the resident until a determination has been made.
Also beneficial is a new rule that regardless of the reason for eviction, the facility must notify not only the resident and/or loved ones of a transfer/discharge, but also the Long Term Care Ombudsman, who serve as advocates in each state for nursing home and assisted living facility residents.
Physicians to Bear Greater Responsibility for Involuntary Transfer/Discharge
Lastly, nursing homes have been known to transfer a patient because they allegedly cannot give a resident the care they require. Although the changes to this standard do not take effect until November 2017, it is expected that the revisions to this policy will deter facilities from transferring and discharging residents because they simply do not want to be responsible for their care. The new rule says that if the move is based on their inability to meet a resident’s needs, the judgment must be accompanied by paperwork from the resident’s physician that details the specific care the resident needs and is not receiving, the attempts the current facility has made to meet those needs, and the programs in place at the receiving facility that will properly address these needs.
Overall, the revisions address some areas of federal regulations that were lacking. The well-being of residents in long term care facilities is the goal of CMS and in adjusting the standards required for involuntary transfer and discharge, CMS has shown that they understand the emotional, physical and financial impact a move under such circumstances can have. Hopefully future data will also show that these recent changes have made a positive impact for residents and the industry as a whole.