Admission / Transfer / Discharge Flashcards Preview

Regulations > Admission / Transfer / Discharge > Flashcards

Flashcards in Admission / Transfer / Discharge Deck (21):

As a condition of Admission into a FACILITY, as part of that process, the FACILITY may NOT require what TYPE of payment?

Both 483.12/19.501
1-Guarantee Third Party of PAYMENT AND
** The deal is GUARANTEE of PAYMENT and Third PARTY
2-IN addition Can Not receive gifts or money ect .. as a condition of Admission, for Medicaid.


When can a FACILITY TRANSFER or DISCHARGE a patient?

Both 483.12/19.502-b
1-Facility can no longer meet the needs of the resident- Dr. Documentation
2-Health- of RESIDENT has Improved enough-Dr. Documentation
3-SAFTY- of others is ENDANGED-
4-HEALTH-of OTHERS is ENDANGED-DR. Documentation
5-PAYMENT -after reasonable and appropriate NOTICE to collect ** 30 day Notice
7-FACILITY - Ceases to operate** 75 day Notice


Who MUST be NOTIFIED and When must NOTICE be given upon a Transfer or Discharge?

Both- 483.12/19.502

2-FAMILY - if known
3- AT least 30 Days
4-5 Days if room change
5-75 Days when facility Ceases to OPERATE as a Medicaid facility
6- As soon as practical when:
Safety/Health/Needs being meet/Requests OR
has not been in the facility for more than 30 days


If a Transfer or Discharge is because of the HEALTH or SAFTY of others in the facility the facility must?

Texas Only-19.502-e-4

1-CALL DADS (consumer rights and Services) to report intentions
2-Submit DADS required DR. Documentation

*** UNLESS the Transfer or Discharge is to a hospital


What must be included in the NOTICE of Transfer or discharge from the facility

Both 483.12/19.502-f

2-DATE of when D/C or transfer will take place
3-LOCATION of D/C or transfer
4-STATEMENT of appeal
5-OMBUDSMAN - contact information

5A-Developmental Disabilities- contact information * if applies** (Fed) -- and only if the NF has this type of resident.
5B-IF has a mental illness: Address and phone of state mental health authority
5C-If has a intellectual or developmental disability-Address and phone of State Authority and State protection and advocacy group.

** Discharge summary can be the LAST progress note


How much prep time must be given to Residents before TRANSFER or DISCHARGE?

Both 483.12/19.502-g-

1-There is no TIME limit, BUT prep for D/C or Transfer must happen, and in enough time to ensure a safe and orderly exit


When a TRANSFER to a NEW ROOM in the SAME Facility takes place, HOW much Notice must be given?
WHO is to be Notified?
HOW is notice to be given?

Texas Only- 19.502-h-

5 Days Notice;
1-Resident AND
Must be written NOTICE that includes: REASON/EFFECTIVE DATE/and the NEW ROOM


What is the time limit on FAIR HEARINGS when a resident receives a DISCHARGE NOTICE? (How many days to appeal)

-Texas Only- 19.502-i-
90 days to appeal


What happens to the RESIDENT if he makes an APPEAL of DISCHARGE before the DISCHARGE effective DATE?

-Texas Only- 19.502
IS allowed to stay in the FACILITY unless;


When two persons are married, when must Discharge/Transfer take place?

-Texas Only-19.502-j-
SAME DAY if POSSIBLE; and then only if the other spouse wants to be TRANSFERD.

*** this request must be in writing


What two policies govern bed hold?

-Both- 483.12/19.503-



What type of Notice is given for BED HOLD? and when is Notice given?

-Both- 483.12/19.503-

1-Must be Written and given at time of TRANSFER or LEAVE.
2-Must be given to Resident AND Family Member


How much can a facility CHARGE for a BEDHOLD

-Texas Only- 19.503-

1-Not to exceed DHS daily Vendor rate.


The discharge summary may be:

** the last PROGRESS NOTE


Before a resident is transferred, a written notice is required specifying all the following except?
1-The right to refuse the transfer
2-location to where is being transferred too.
3-a statement that the resident has the right to appeal the action to the state
4-the name, address, and telephone number of the state nursing home association

4-the name, address, and telephone number of the state nursing home association

**(5) the name, address, and telephone number of the regional representative of the Office of the State Long Term Care Ombudsman

Also must include:
Effective Date


Regardless of transfer type, what must nurse do?

Nurse must document the transfer in the clinical record.

Only time not required is when it is requested by family or resident. -Texas Only-


If a resident is private pay, and later converts to Medicaid rate, can this be deemed worthy of non-payment , and subject to the 30 notice and transfer or discharge?

No, switch of payment dose not constituent "non-payment"


How many bed hold policies need to be issued? And when must they be issued?

1- 2 notices must be given
2- The first need to be given "well in advance" of a bed-hold
3- The 2ed must be given at time of transfer.


When must facility give notification to family(ect) of an "emergency" transfer?

24 hours

** this requirement can be met if the residents copy is sent with the resident to the hospital.


What are the re-admit bed hold rules for Private pay/ Medicaid / Medicare?

If leave is over state bed-hold limit resident:
Private pay: is required to pay for all bed hold stays

1-Can pay of out pocket days not covered.
2-However, must be re-admitted to semi private room, once facility has room, regardless if owes money.
3-if dose owe money facility can start the process of non-payment after has been re-admitted.


When is the only time(s) that the clinical record does not need to be documented on a transfer or discharge in a medicaid facility?

1-The resident , or the family or REP requests a transfer or discharge
2-The facility ceases to operate as a nursing facility.