16 Del. Admin. Code § 3102-4.0

Current through Register Vol. 28, No. 7, January 1, 2025

Section 3102-4.0 - Transfer, discharge and readmission rights of residents of a Long-Term Care Facility as defined in 16 Del.C Section 1102(b)(4). See 16 Del.C. Section 1127

4.1 "Transfer and discharge" includes movement of a resident to a location outside of the licensed facility.

4.2 Transfer and discharge requirements. The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility except for:

4.2.1 Medical needs which cannot be met in the facility;

4.2.2 The resident's own welfare;

4.2.3 The welfare of the other individuals in the facility;

4.2.4 Nonpayment of justified charges, after appropriate notice; or

4.2.5 Termination of facility operation.

4.3 Documentation. When the facility transfers or discharges a resident under any of the circumstances specified in subsection 4.2.1 or 4.2.2 of this regulation, the resident's clinical record must be documented. The documentation must be made by:

4.3.1 The resident's physician when transfer or discharge is necessary in subsection 4.2.1 or 4.2.2 of this regulation; and

4.3.2 A physician when transfer or discharge is necessary in subsection 4.2.3 of this regulation.

4.4 Notice before transfer. Before a facility transfers or discharges a resident, the facility must:

4.4.1 Notify the resident and, if known, a family member or legal representative, of the resident of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand.

4.4.2 Record the reasons in the resident's clinical record; and

4.4.3 Include in the notice the items described in subsection 4.6 of this regulation.

4.5 Timing of the notice. Except as specified in subsections 4.5.1 and 4.9 of this regulation, the notice of transfer or discharge required in subsection 4.4 of this regulation must be made by the facility at least 30 days before the resident is transferred or discharged.

4.5.1 Notice may be made as soon as practicable before or after transfer or discharge when:

4.5.1.1 The welfare of individuals in the facility would be endangered in subsection 4.2.3 of this regulation; or

4.5.1.2 An immediate transfer or discharge is required by the resident's urgent medical needs, in subsection 4.2.1 of this regulation;

4.6 Contents of the notice. The written notice specified in subsection 4.4 of this regulation must include the following:

4.6.1 The reason for transfer or discharge. A detailed individualized explanation of the reason or reasons for the action being taken which includes, in terms understandable to the resident:

4.6.1.1 A statement of what action the agency intends to take;

4.6.1.2 The reasons for the intended action, including any information needed for the resident to determine from the notice alone the accuracy of the facilities intended action. When the reason is non-payment, an itemized statement of the resident's account for the preceding 12 months; and

4.6.1.3 The specific policy or regulation supporting such action.

4.6.2 The effective date of transfer or discharge;

4.6.3 The location to which the resident will be transferred or discharged;

4.6.4 A statement of the resident's right to a fair hearing as provided in this section:

4.6.4.1 The method by which the resident may request a fair hearing; and

4.6.4.2 A statement that the resident may represent him or herself or may be represented by counsel or by another person.

4.6.5 The name, address and telephone number of the State LTC Ombudsman; and

4.6.6 For nursing facility residents with a developmental disability or mental illness, the mailing address and telephone number of the Delaware protection and advocacy agency as defined in 16 Del.C. § 1102(7).

4.7 Orientation for transfer or discharge. A facility must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility.

4.8 Notice in advance of facility closure. In the case of facility closure, the individual who is the administrator of the facility must provide written notification prior to the impending closure to Division, the State LTC Ombudsman, residents of the facility, and the legal representatives of the residents or other responsible parties, as well as the plan for the transfer and adequate relocation of the residents. The notice shall be provided as far in advance of closure as possible.

4.9 Room changes.

4.9.1 Room changes in a facility must be limited to moves within the particular building in which the resident resides, unless the resident voluntarily agrees to move to another location. A facility's discretion to transfer residents to another room is limited by 16 Del.C. § 1121(b)(34).

4.9.2 The facility must give reasonable notice before the resident's room or roommate is changed, except in emergencies.

4.9.3 The facility shall endeavor to honor roommate requests whenever possible.

4.10 Notice of bed-hold policy and readmission.

4.10.1 Notice before transfer. When a nursing facility transfers a resident out of a facility to an acute care facility it must provide written information to the resident and a family member or legal representative that specifies that the facility must accept the patient or resident back into the facility when the resident no longer needs acute care and there is space available in the facility. If no space is available, the resident shall be accepted into the next available bed.

4.10.2 Permitting resident to return to facility. A nursing facility must establish and follow a written policy for implementing its obligation to immediately offer the first available bed to a resident who is entitled to be readmitted to the facility when acute care is no longer required.

16 Del. Admin. Code § 3102-4.0

24 DE Reg. 275( 9/1/2020) (final)