Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-10 - NURSING FACILITIES › Section 420-5-10-.06 - Admission, Transfer, Transport And Discharge Rights

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Admissions, transfers, transport and
			 discharge.
(a) Transfer and discharge
			 includes movement of a resident to a bed outside of the certified facility
			 whether that bed is in the same physical plant or not. Transfer and discharge
			 does not refer to movement of a resident to a bed within the same certified
			 facility.
(b) The facility must
			 permit each resident to remain in the facility, and not transfer or discharge
			 the resident from the facility unless--
1.
			 The transfer or discharge is necessary for the resident's welfare and the
			 resident's needs cannot be met in the facility;
2. The transfer or discharge is appropriate
			 because the resident's health has improved sufficiently so the resident no
			 longer needs the services provided by the facility;
3. The safety of individuals in the facility
			 is endangered;
4. The health of
			 individuals in the facility would otherwise be endangered;
5. The resident has failed, after reasonable
			 and appropriate notice, to pay for (or to have paid under Medicare or Medicaid)
			 a stay at the facility. For a resident who becomes eligible for Medicaid after
			 admission to a nursing facility, the nursing facility may charge a resident
			 only allowable charges under Medicaid; or
6. The facility ceases to operate.
(c) Documentation. When the
			 facility transfers or discharges a resident under any of the circumstances
			 specified in this section, the resident's clinical record must be documented.
			 The documentation must be made by--
1. The
			 resident's physician when transfer or discharge is necessary under paragraph
			 (1)(b)1 or paragraph (1)(b)2 of this section; and
2. A physician when transfer or discharge is
			 necessary under paragraph (1)(b)4 of this section.
(d) Notice before transfer. Before a facility
			 transfers or discharges a resident, the facility must--
1. Notify the resident and, if known, a
			 family members 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.
2. Record the
			 reasons in the resident's clinical record; and
3. Include in the notice the items described
			 in paragraph (f)l of this section.
(e) Timing of the notice. Except when
			 specified in paragraph (e)1 of this section, the notice of transfer or
			 discharge required under paragraph (d) 1 of this section must be made by the
			 facility at least 30 days before the resident is transferred or discharged.
1. Notice may be made as soon as practicable
			 before transfer or discharge when--
(i) The
			 safety of individuals in the facility would be endangered, under paragraph (1)
			 (b)3 of this section.
(ii) The
			 health of individuals in the facility would be endangered, under (1)(b)4 of
			 this section.
(iii) The resident's
			 health improves sufficiently to allow a more immediate transfer or discharge,
			 under paragraph (1)(b)2 of this section;
(iv) An immediate transfer or discharge is
			 required by the resident's urgent medical needs, under paragraph (1)(b)1 of
			 this section; or
(v) A resident has
			 not resided in the facility for 30 days.
(f) Contents of the notice. The written
			 notice specified in paragraph (d) of this section must include the following:
1. The reason for transfer or
			 discharge;
2. The effective date of
			 transfer or discharge;
3. The
			 location to which the resident is transferred or discharged;
4. A statement that the resident has the
			 right to appeal the action to the State;
5. The name, address and telephone number of
			 the State long term care ombudsman;
6. For nursing facility residents with
			 developmental disabilities, or are mentally ill, the mailing address and
			 telephone number of the Alabama Developmental Disabilities Advocacy Program
			 (ADDAP) at the University of Alabama School of Law; and
(g) 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.
(h) Resident Transport. If a resident is
			 unable to ride in an upright position or if such resident's condition is such
			 that he or she needs observation or treatment by Emergency Medical Services
			 personnel, or if the resident requires transportation on a stretcher, gurney or
			 cot, the facility shall arrange or request transportation services only from
			 providers who are ambulance service operators licensed by the Alabama State
			 Board of Health. If such resident is being transported to or from a health care
			 facility in another state, transportation services may be arranged with a
			 transport provider licensed as an ambulance service operator in that state. For
			 the purposes of this rule, and upright position means no more than 20 degrees
			 from vertical.