Background
Title 42 CFR section 483.15(c)(3)-(6) provides the notice requirements for facility-initiated transfers and discharges, including discharges that occur while the resident remains in the hospital after an emergency transfer. HSC section 1599.1(i) requires SNFs to comply with Title 42 CFR section 483.15, regardless of a resident's payment source or the Medi-Cal or Medicare certification status of the SNF in which the resident resides, except that a noncertified facility is not obligated to provide notice of Medicaid or Medicare benefits, covered services, or eligibility procedures.
Notice Before Transfer or Discharge
Pursuant to Title 42 CFR
section 483.15(c)(3), before a SNF transfers or discharges a resident, the SNF must:
Contents of the Notice
The facility's notice must include all of the following at the time notice is provided:
- The specific reason for the transfer or discharge, including the basis under Title 42 CFR section 483.15(c)(1)(i)(A)-(F).
- The effective date of transfer or discharge.
- The specific location (such as the name of the new provider or description and/or address if the location is a residence) to which the resident is to be transferred or discharged.
- An explanation of the right to appeal the transfer or discharge to the State (Department of Health Care Services (DHCS), Office of Administrative Hearings and Appeals (OAHA)).
- The name, address (mail and email), and telephone number of the state entity which receives such appeal hearing requests (DHCS OAHA, Transfer Discharge and Refusal to Readmit Unit).
- Information on how to obtain an appeal form.
- Information on obtaining assistance in completing and submitting the appeal hearing request.
- The name, address (mailing and email), and phone number of the representative of the Office of the State LTC Ombudsman.
For nursing facility residents with intellectual and developmental disabilities (or related disabilities) or with mental illness (or related disabilities), the notice must include the name, mailing and e-mail addresses, and phone number of the agency responsible for the protection and advocacy for these populations (Disability Rights California, Get Help Webpage).
Timing of The Notice
Notice must be provided at least 30 days prior to the transfer or discharge of the resident. Exceptions to the 30-day requirement apply when the transfer or discharge is affected because:
- The health and/or safety of individuals in the facility would be endangered due to the clinical or behavioral status of the resident.
- The resident's health improves sufficiently to allow a more immediate transfer or discharge.
- An immediate transfer or discharge is required by the resident's urgent medical needs; or
- A resident has not resided in the facility for 30 days.
In these exceptional cases, the notice must be provided to the resident, resident's representative(s) if appropriate, and LTC ombudsman as soon as practicable before the transfer or discharge.
The information in this AFL is a brief summary of the laws and regulations governing the rights of resident and the resident's representative(s) on receiving a notification of transfer or discharge from a SNF. SNFs are responsible for complying with all applicable laws. Consequences of not complying will result in a deficiency that can lead to a citation and/or civil action against the licensee of the SNF.
For more information regarding rights, admission, and transfer and discharge requirements, refer to the California Standard Admission Agreement (PDF) and the applicable state and federal requirements referenced above.
If you have questions, please contact your respective district office.
Sincerely,
Original signed by Mandi Posner
Mandi Posner
Deputy Director