On September 30, 2016, CMS, which is part of the Department of Health and Human Services (HHS) and which is the agency responsible for administering Medicare, Medicaid, and other programs, issued new nursing home regulations. There are several important updates, of which I will highlight two:
A Primer On Transfer/Discharge Rights
It is important to know that under Florida law, there are only three reasons a facility can discharge a resident from a nursing home: 1) For medical reasons; 2) For the welfare of other residents; 3) For non-payment of a bill after a 30 day notice. The Florida statute specifically states that a nursing home may NOT discharge a patient because the source of payment has changed (i.e., from private pay or Medicare to Medicaid).
Under the federal regulations, there are six reasons that a nursing home can discharge a resident: 1) The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility; 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 facility, the facility may charge a resident only allowable charges under Medicaid; or 6) The facility ceases to operate.
There are also requirements for the form of the discharge notice and certain information it needs to contain.
If you feel that you or a loved one has been wrongfully discharged from a nursing home facility in Florida, you should file a Request for Fair Hearing within ten (10) days of the date of the notice, then the discharge MUST be stayed pending the outcome of the administrative hearing.