January 25, 2018
Dear Nursing Home Administrators:
It has come to the attention of the Office of the State Long Term Care Ombudsman as well as to New York State DOH that there are many questions regarding proper notification to the Regional Long Term Care Ombudsman Officesupon the transfer or discharge of a resident as set forth in 42 CRF 483.15 effective November 28, 2016.
The regulation at 42 CFR 483.15(c)(3)(i) requires, in part, that before a facility transfers or discharges a resident, the facility must “notify the resident and the resident’s representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand….”
42 CFR 483.15(c)(3)(i) states:
(3) Notice before transfer. Before a facility transfers or discharges a resident, the facility must -
(i) Notify the resident and the resident's representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand. The facility must send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman.
The new requirement of participation rules and CMS guidance (S&C 17-27 NH May 12, 2017) states that all facility-initiated or involuntary discharge and transfer notices must be sent to the Office of the State Ombudsman at the time of issuance to the resident. Per the regulation, only the discharge notice need be sent to the Ombudsman Program for each facility-initiated or involuntary discharge. Facilities do not need to send resident discharge instructions or medical records, only the discharge notice issued to the resident and/or the resident representative.
Regarding emergency transfers or transfers to acute care facilities, the guidance is thenotice of the transfer may be provided to the resident and resident representative as soon as practicable, according to 42 CFR 483.15(c)(4)(ii)(D). Copies of notices for emergency transfers must also still be sent to the ombudsman, but they may be sent when practicable, such as in a list of residents on a monthly basis.A list should not be sent of all discharges, a list may only be sent for emergency transfers/hospital transfers. As mentioned, any other facility-initiated or involuntary discharge notice should be sent at the same time the resident and/or representative receives it.
To further help facilitate this process, we would like to provide you clarification for sending the discharge notices. Please utilize the below information to send the notices to your Regional Long Term Care Ombudsman Office:
Region 11 (Broome, Chenango, Delaware & Tioga)
Or fax at 607-722-1293
The Office of the State Long Term Care Ombudsman and its regional offices appreciate your efforts to ensure residents’ rights are promoted and protected at your facility. If you have any questions regarding this letter of clarification please contact your Regional Ombudsman Program at 607-722-1251
Sincerely,
Rebecca A. Bradley
Regional Ombudsman Coordinator
Claudette Royal, State Ombudsman