DISCHARGE PLANNING BY STATE - medicareadvocacy.org

1 DISCHARGE PLANNING BY STATE . Alabama Missouri Alaska Montana Arkansas Nebraska Arizona Nevada California New Hampshire Colorado New Jersey Connecticut New Mexico Delaware New York District of Columbia North Carolina Florida North Dakota Georgia Ohio Hawaii Oklahoma Idaho Oregon Illinois Pennsylvania Indiana Rhode Island Iowa South Carolina Kansas South Dakota Kentucky Tennessee Louisiana Texas Maine Utah Maryland Vermont Massachusetts Virginia Michigan Washington STATE Minnesota West Virginia Wisconsin Wyoming Alabama Common DISCHARGE Provisions at a Glance Alabama Detailed DISCHARGE PLANNING Alabama Common DISCHARGE Provision at a Glance Applies to Nursing and Similar Facilities YES. Applies to Assisted Living Facilities NO. Applies to Hospice NO. Applies to Hospitals NO. Requires notice to patient prior to 30 Days DISCHARGE Limits reason for transfer or DISCHARGE : If necessary for resident's welfare and YES.

2 Needs cannot be met in the facility Resident's health has improved and he YES. or she no longer needs the services provided by the facility The safety of individuals in the facility YES. are endangered The health of individuals in the YES. facility are endangered The resident has failed to pay after YES. reasonable and appropriate notice given The facility ceases to operate YES. For medical reasons NO. It is essential to meet the facility's NO. reasonable administrative needs and no practicable alternative is available If the patient is a Medicare/Medicaid NO. beneficiary and the home no longer participates in the program Has process for appeal of DISCHARGE or YES. transfer decisions Requires DISCHARGE Plan YES. Provides for residents or their advocates YES. to participate in development of care plan or DISCHARGE PLANNING DISCHARGE plan/reasons for DISCHARGE must NO.

3 Be documented in patient's record Requires that patients receive orally or in YES. writing their DISCHARGE care plan or reasons for DISCHARGE Requires each facility to develop is own NO. DISCHARGE policy Alabama Detailed DISCHARGE PLANNING Nursing Facilities (Ala. Admin. Code 420-5-10 Division of Licensure and Certification, Nursing Facilities) (Adapted from Ala. Admin. Code , , , ). When a facility anticipates DISCHARGE , they must notify the resident, consult the resident's physician, and notify the legal representative or interested family member IMMEDIATELY when the facility decides to DISCHARGE a resident. ( ). When discharged, a resident must have a DISCHARGE summary Requirements for DISCHARGE Summary 1. A brief review or summary of the resident's stay 2. A final summary of the resident's status including at least: a. Medically defined conditions and prior medical history.

4 B. medical status measurement;. c. Physical and mental functional status;. d. Sensory and physical impairments;. e. Nutritional status and requirements;. f. Special treatments or procedures;. g. Mental and psychosocial status;. h. DISCHARGE potential;. i. Dental condition;. j. Activities potential;. k. Rehabilitation potential;. l. Cognitive status; and m. Drug therapy 3. This final summary must be available for release to authorized persons and agencies with the consent of the resident or legal representative at the time of resident's DISCHARGE 4. A post- DISCHARGE plan of care, developed with the participation of the resident and his or her family, to assist the resident in adjusting to his or her new living environment The facility may only DISCHARGE you if: 1. The transfer or DISCHARGE is necessary for the resident's welfare and the resident's needs cannot be met in the facility.

5 2. The transfer or DISCHARGE is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility;. 3. The safety of individuals in the facility is endangered;. 4. The health of individuals in the facility would otherwise be endangered;. 5. The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility. For a resident who becomes eligible for Medicaid after admission to a nursing facility, the nursing facility may charge a resident only allowable charges under Medicaid; or 6. The facility ceases to operate. The facility must give 30 days notice of the DISCHARGE unless: (i) The safety of individuals in the facility would be endangered, under paragraph (1) (b)3 of this section. (ii) The health of individuals in the facility would be endangered, under (1)(b)4 of this section.

6 (iii) The resident's health improves sufficiently to allow a more immediate transfer or DISCHARGE , under paragraph (1)(b)2 of this section;. (iv) An immediate transfer or DISCHARGE is required by the resident's urgent medical needs, under paragraph (1)(b)1 of this section; or (v) A resident has not resided in the facility for 30 days. The Notice of DISCHARGE or Transfer Must Include: 1. The reason for transfer or DISCHARGE ;. 2. The effective date of transfer or DISCHARGE ;. 3. The location to which the resident is transferred or discharged;. 4. A statement that the resident has the right to appeal the action to the STATE ;. 5. The name, address and telephone number of the STATE long term care ombudsman;. 6. For nursing facility residents with developmental disabilities, or are mentally ill, the mailing address and telephone number of the Alabama Developmental Disabilities Advocacy Program (ADDAP) at the University of Alabama School of Law; and 7.

7 Orientation for transfer or DISCHARGE . A facility must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or DISCHARGE from the facility. There is a basic grievances process outlined ( ). Grievances. A resident has the right to: 1. Voice grievances without discrimination or reprisal. Such grievances include those with respect to treatment which has been furnished as well as that which has not been furnished; and 2. Prompt efforts by the facility to resolve grievances the resident may have, including those with respect to the behavior of other residents. Source: Alabama STATE Board Of Health Alabama Department Of Public Health Chapter -Page Up- - DISCHARGE PLANNING Main- Alaska Common DISCHARGE Provisions at a Glance Alaska Detailed DISCHARGE PLANNING Alaska Common DISCHARGE Provisions at a Glance Applies to Nursing and Similar Facilities YES.

8 Applies to Assisted Living Facilities NO. Applies to Hospice NO. Applies to Hospitals YES. Requires notice to patient prior to NO. DISCHARGE Limits reason for transfer or DISCHARGE : If necessary for resident's welfare and needs cannot be met in the facility NO. Resident's health has improved and he NO. or she no longer needs the services provided by the facility The safety of individuals in the facility NO. are endangered The health of individuals in the NO. facility are endangered The resident has failed to pay after NO. reasonable and appropriate notice given The facility ceases to operate NO. For medical reasons NO. It is essential to meet the facility's NO. reasonable administrative needs and no practicable alternative is available If the patient is a Medicare/Medicaid NO. beneficiary and the home no longer participates in the program Has process for appeal of DISCHARGE or NO.

9 Transfer decisions Requires DISCHARGE Plan NO. Provides for residents or their advocates YES. to participate in development of care plan or DISCHARGE PLANNING DISCHARGE plan/reasons for DISCHARGE must NO. be documented in patient's record Requires that patients receive orally or in YES. writing their DISCHARGE care plan or reasons for DISCHARGE Requires each facility to develop is own NO. DISCHARGE policy Detailed Alaska DISCHARGE PLANNING 7 Alaska Admin. Code Patient's Rights 7 Alaska Admin. Code Facilities and Local Units, General Provisions A patient, client, or nursing facility resident has rights that include the following: (13) to participate in the development of a plan of care, or DISCHARGE plan, and to receive instructions for self-care and treatment that include explanation of adverse symptoms and necessary precautions, as appropriate;. This applies to patients, clients, or residents in: 1.

10 Acute Care Hospitals 2. Rural Primary Care Hospitals 3. Long-term Acute Care Hospitals 4. Critical Access Hospitals 5. Specialized hospitals 6. Nursing Facilities 7. Ambulatory Surgical Facilities 8. Free Standing Birth Centers 9. Frontier Extended Stay Clinics (7 AAC b, d, e, h). Source: Alaska Patient's Rights -Page Up- - DISCHARGE PLANNING Main- Arkansas Common DISCHARGE Provisions at a Glance Detailed Arkansas DISCHARGE PLANNING Arkansas Common DISCHARGE Provisions at a Glance Applies to Nursing and Similar Facilities NO. Applies to Hospitals YES. Applies to Assisted Living Facilities NO. Applies to Hospice NO. Requires notice to patient prior to NO. DISCHARGE Limits reason for transfer or DISCHARGE : If necessary for resident's welfare and needs cannot be met in the facility NO. Resident's health has improved and he NO. or she no longer needs the services provided by the facility The safety of individuals in the facility NO.