HB 0388

CHAPTER 111

HB 388 - FINAL VERSION

AN ACT clarifying the rights of patients of nursing facilities in the event of a proposed transfer or discharge from the facility.

SPONSORS: Rep. Emerton, Hills 7

This bill clarifies the rights of patients of nursing facilities in the event of a proposed transfer or discharge from a facility.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT clarifying the rights of patients of nursing facilities in the event of a proposed transfer or discharge from the facility.

Be it Enacted by the Senate and House of Representatives in General Court convened:

111:1 New Paragraph; Definition Added; Discharge. Amend RSA 151:19 by inserting after paragraph I the following new paragraph:

I-a. "Discharge" means movement of a patient from a facility to a noninstitutional setting when the discharging facility ceases to be legally responsible for the care of the patient.

111:2 New Paragraph; Definition Added; Transfer. Amend RSA 151:19 by inserting after paragraph VI the following new paragraph:

VII. "Transfer" means movement of a patient from one facility to another facility when the legal responsibility for the care of the patient changes from the transferring to the receiving facility. Transfer shall not include the temporary movement of a patient from a facility to a hospital or other location for emergency medical treatment, as long as the facility is in compliance with RSA 151:25. In the event a facility refuses to readmit a patient in accordance with RSA 151:25 following a therapeutic leave, a transfer shall be deemed to have occurred when the decision not to readmit is made.

II. When a patient's absence is longer than 10 days, or the facility has not received payment for the period of absence, the patient shall have the option to return to the facility for the next available bed.

111:4 Transfer or Discharge of Patients. RSA 151:26 is repealed and reenacted to read as follows:

I. A facility shall not transfer or discharge a patient except for those reasons listed under RSA 151:21, V.

II.(a) Transfer or discharge of a patient shall in all instances be preceded by written notice which shall contain the following:

(4) The name, address and telephone number of the long-term care ombudsman, established under RSA 161-F:10, and the name, address, and telephone number of the designated agency responsible for the protection and advocacy system for a developmentally disabled or mentally ill individual;

(5) A statement which shall read: "You have a right to appeal the facility's decision to transfer or discharge you. If you think you should not have to leave this facility, you may file an appeal in superior or probate court." If the patient is in a skilled nursing facility or nursing facility certified under Title XVIII or Title XIX of the Social Security Act, the statement shall inform the patient of his or her right to request an administrative hearing before the department of health and human services.

Except as specified in paragraph II(b) of this section, written notice of transfer or discharge shall be given at least 30 days before the resident is transferred or discharged. A copy of the notice shall be placed in the patient's clinical record and a copy shall be transmitted to the patient, the patient's next of kin, the patient's personal representative, legal guardian, the long-term ombudsman in the office of the ombudsman established under RSA 161-F:10, the designated agency responsible for the protection and advocacy system for a developmentally disabled or mentally ill individual, and the person or agency responsible for the patient's placement, maintenance, and care in the facility.

(b) Written notice as specified in subparagraph II(a) shall be given as soon as practicable before transfer or discharge in the following circumstances:

(1) If an emergency transfer or discharge is mandated by the patient's health care needs and is in accord with the written orders and medical justification of the patient's physician or advanced registered nurse practitioner (ARNP);

(2) If the transfer or discharge is mandated by the health or safety of other individuals in the facility, as documented in the patient's clinical record upon consultation with the patient's physician or advanced registered nurse practitioner (ARNP);

(3) If the patient's health has improved sufficiently so the patient no longer needs the services provided by the facility, as documented in the patient's clinical record by the patient's physician or advanced registered nurse practitioner (ARNP); or

(c) The basis for the transfer or discharge shall be documented in the patient's clinical record. The facility shall consult with the patient's physician or advanced registered nurse practitioner prior to transferring or discharging the patient for medical reasons or for the patient's welfare or that of other patients. The documentation of the basis for the transfer or discharge shall be made by:

(1) The patient's physician or advanced registered nurse practitioner (ARNP) if the transfer or discharge is necessary because the patient's needs cannot be met in the facility;

(2) The patient's physician or advanced registered nurse practitioner (ARNP) if the transfer or discharge is appropriate because the patient's health has improved sufficiently so the patient no longer needs the services provided by the facility;

(3) A physician or advanced registered nurse practitioner (ARNP) if the health of individuals in the facility would be endangered.

III. Transfer or discharge of a patient of a skilled nursing facility or nursing facility certified under Title XVIII or Title XIX of the Social Security Act shall take into account any additional rights and safeguards prescribed by the commissioner of the department of health and human services and the secretary of the United States Department of Health and Human Services.

IV. Upon notice, a patient may petition the superior or probate court to enjoin the facility's decision to transfer or discharge. This petition shall stay any transfer or discharge pending a decision.