Nursing Home Involuntary Discharge and Transfer FAQ
Can a nursing home transfer or discharge me?
Nursing homes can only discharge or transfer residents for very limited reasons. If you do not agree to leave, it is called an involuntary transfer or discharge. Federal and state laws have strict rules about involuntary transfers and discharges. In most cases, there are only five reasons a nursing home can involuntarily transfer or discharge you:
- A transfer or discharge is necessary for your welfare and your needs cannot be met by the nursing home. Your doctor must write in your medical chart why the discharge or transfer is necessary.
- The transfer or discharge is appropriate because your health has improved sufficiently so that you no longer need the services provided by the facility. Your doctor must write in your medical chart why the discharge or transfer is appropriate.
- You are endangering the health or safety of an individual in the nursing home. A doctor must write in your medical chart why the discharge or transfer is necessary.
- You have failed to pay or have others pay the nursing home for your stay. The facility must have given you reasonable and appropriate notice of the amount you owe.
- The facility has stopped operating or, if you are a Medicare or Medicaid recipient, the facility has been decertified or withdrawn from the program. Read the Law: MD Code Health-General § 19-345
Do I receive advance notice of a discharge or transfer?
The nursing home must give you a written notice at least 30 days before the proposed transfer or discharge date. A continuing care retirement community must provide 60 days notice. The notice must also be sent to the local Long Term Care Ombudsman, the Department of Health, and any of your relatives who have acted as your representative. Read the Law: MD Code Health - General § 19-345.1
What does the notice of discharge or transfer have to tell me?
The notice must have all the items listed below:
- Each reason for the proposed involuntary discharge or transfer.
- Your right to request a hearing, and how to request a hearing.
- The name, address, and phone number of the Maryland Department of Aging and Long Term Care Ombudsman.
- Your right to consult with a lawyer.
- The name, address and phone number of Maryland Legal Aid, the Older Americans Act Senior Legal Assistance Programs, and other agencies. If you are a person with developmental disabilities or mental illness, the address and phone number of the Maryland Disability Law Center.
- The date on which the proposed transfer or discharge will take place.
- Your rights to a safe and secure transfer or discharge.
If the notice does not contain all the information above, or if it is not sent properly to everyone who should get the
notice, you can challenge the discharge because the notice was not valid. Read the Law: MD Code Health - General § 19-345.1
Are there any reasons why the nursing home doesn’t have to give me notice?
The nursing home does not have to provide you with 30 days notice and an opportunity for a hearing if:
- There is an emergency and the health and safety of you or other residents is in immediate and serious danger, or
- You have been at the less than 30 daysRead the Law: MD Code Health - General § 19-345.1
How can I stop the nursing home from discharging or transferring me?
There are several ways that you can try to stop the transfer or discharge. As soon as you get the notice of discharge you should:
- Request mediation and a hearing. You have 30 days from the date you received the notice of discharge or transfer to ask for mediation and a hearing. This is also called filing an appeal. Your Notice of Discharge tells you how to file the appeal with the Office of Administrative Hearings. If you file an appeal within 30 days, the nursing home cannot transfer or discharge you until an Administrative Law Judge makes a final decision at your hearing.
- Contact the Ombudsman. You should call the Long Term Care Ombudsman for assistance. The Ombudsman is a free advocate for residents who will try to help resolve your problem. They will also report serious cases to the appropriate authorities and may refer you to an attorney. The Ombudsman makes regular visits to nursing homes. To find your local Ombudsman, call the statewide office at 1-800-243-3425, ext. 71108, or go to http://www.aging.maryland.gov/Ombudsman.html.
What else can I do if the nursing home is not following the proper procedure for transfer or discharge?
- File a complaint with the Maryland Office of Health Care Quality (OHCQ). OHCQ investigates complaints about nursing homes. If you file a complaint, it must investigate your matter promptly. OHCQ may impose severe fines if the nursing home is found at fault. These fines can be up to $10,000. You can file a complaint with OHCQ by calling 1-877-402-8219.
- File a lawsuit requesting an injunction. You may file a lawsuit against the nursing home in the state circuit court asking for an “injunction” if you believe that a transfer or discharge violates the law. An injunction is a court order telling the nursing home not to transfer or discharge you. Your agent, your attorney, or the Attorney General on your behalf can also ask for this court order. This is a difficult thing to do by yourself. If you want to file a lawsuit, you should definitely talk to a lawyer as soon as possible.
What happens if I am discharged or transferred?
You may only be transferred or discharged to a safe and secure place that can meet your needs. It doesn’t matter what the reason is for the transfer or discharge. It doesn’t matter how long you were in the nursing home. It doesn’t matter if it is an emergency. Your transfer or discharge must be safe and secure. The nursing home must
provide you with all of these items:
- Comprehensive medical assessment.
- Post-discharge plan of care.
- Written confirmation from your attending physician that the transfer or discharge complies with the post-discharge plan and that it will not harm your medical condition.
- Statement of medical evaluation.
- List of current medications.
- At least a three day supply of your current medications.
- The information necessary to assist you in getting additional prescriptions for necessary medication.
- A written statement of the date and time you will be discharged, how you will be discharged, and where you will be sent.
If you don’t get something on this list, you can challenge the transfer or discharge. Read the Law: MD Code Health - General § 19-345.2