You’ve been called into a staff meeting. It’s not any staff meeting though. There are a number of residents that are being discharged or transferred.
The first is a woman that is behind in payments but Medicaid is considering paying for her care.
The second is a man who no longer requires care but has been refusing to leave as he is happy in the facility.
The third is a woman who is continually violent and has injured two of the staff and another resident in the last week.
What do you do?
- Nothing, all of the discharges and transfers are perfectly fine.
- Inform your manager that the man who no longer needs care but is happy in the facility should be allowed to stay.
- Inform your manager that the woman who is behind with her payments should be discharged immediately.
- Inform your manager that the woman who is behind on her payments cannot be transferred or discharged until MediCaid makes a determination.
If you said number 4, then you are right. What we are looking at here is regulation F622 which deals with the situations that allow for residents to be transferred or discharged. According to F622 there are only six situations when a resident can be transferred or discharged when it is initiated by the facility.
- The facility cannot meet the needs of the resident
- The resident no longer requires care at the facility
- The resident endangers the safety of others in the facility
- The resident endangers the health of others in the facility
- Failure to pay on the part of the resident (or Medicare, or Medicaid)
- The facility is closing
So let’s take a long back at the four residents being discharged or transferred.
The woman who is behind on her payments but Medicaid is considering paying for her care looks like she fits into the fifth of the criteria. As long as Medicare or Medicaid are considering and haven’t rejected an application for payment of care, the resident can’t be deemed as being behind on their payments.
The man who no longer requires care can be transferred or discharged, no matter whether he wants to go or not.
The woman who is violent and injuring people is endangering the staff and others in the facility can be discharged/transferred immediately.
Knowing these six criteria, and the exceptions, when they apply and when they don’t, will help your facility to run more smoothly, especially when it comes to transfers and discharges. This will help you to have a much less stressful time at work, offer better care to your residents and lead to greater job satisfaction.
Sign up for one of the online courses that SSDOnlineTrainingbyJodyGiac.com offers to help you understand the transfer and discharge process. These courses packed with a wealth of information and experience gained from Jody’s 35 years of experience in the industry.