Q:
If a skilled or private pay resident is sent out to the hospital and the resident’s representative does not want to pay to hold the bed, is this an allowable discharge?
A:
No, you must permit them to readmit to the next available bed if your facility can still meet the needs of the resident. If you cannot meet the resident’s needs (example, chest tube that the hospital placed,) then you are not obligated to readmit the resident. In this situation, you must have evidence that the resident’s status at the time the resident seeks to return to the facility (not at the time the resident was transferred for acute care) meets one of the criteria at 483.15(c)(1)(i)(A) through (D). Additionally, the resident has the right to return to the facility pending an appeal of any facility-initiated discharge unless the return would endanger the health or safety of the resident or other individuals in the facility. The facility must document the danger that the failure to transfer or discharge would pose. (§483.15(c)(1)(ii)).
Shelly Maffia RN, MSN, MBA, LNHA, QCP, CHC, CLNC, CPC
Director of Regulatory Services
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