It is important to understand the policy of involuntary discharges. An involuntary discharge is when a long-term care facility wants to evict or transfer a resident from their facility. The start of this process occurs when a 30-Day Discharge Notice is issued.

What is the Process of a 30-Day Discharge Notice?

• Firstly, the resident, guardian, or responsible party must be notified.
• By law, The Rhode Island Long Term Care Ombudsman Office must be notified as well.
• The nursing home must provide a valid reason for issuing the 30-Day Notice.

Valid Reasons for Issuing a 30-Day Discharge Notice:

1. The nursing home cannot meet the resident’s needs.
2. The resident no longer requires a nursing home level of care.
3. The resident endangers the safety and health of other residents.
4. An alert resident refuses to pay the facility (this does not apply to residents with Dementia or residents who have someone else handling their finances.
5. The nursing home is closing.

Invalid Reasons for Issuing a 30-Day Discharge Notice:

1. The resident is not compliant and will not follow rules. This would depend on what measures have been employed by the facility to explain to the resident why their behaviors are a danger to themselves, other residents, or staff.
2. A resident’s care is too expensive. Once the person is admitted, the facility must meet their needs – no matter the cost.
3. The resident’s Medicare eligibility has run out. This is the case unless the admission contract clearly defines that a resident will have to find another facility or pay privately when Medicare no longer pays for their care. Keep in mind that the resident, their family, or the responsible party should carefully read the forms they sign on admission day.

The Right to Appeal a 30-Day Discharge Notice

All residents have the right to appeal a 30-Day Discharge Notice.

• A facility cannot discharge a resident while the appeal process is taking place.
• There may be others that should receive a copy of the 30-Day Notice, for example, the Mental Health Advocate. The 30-Day Notice will show to whom other copies were sent.
• The nursing home must list a destination for the resident to go to if the facility wins the appeal. Discharging someone to a shelter or to the street is not an appropriate discharge. The only exception to this is if a competent resident requests this. If there is no other facility willing to take the resident, then the resident stays.

The benefit of working with the Long Term Care Ombudsman Office is that our staff can, most of the time, work out an agreement between all parties. The Ombudsman can also accompany the resident to the hearing either in person or by Zoom. Most situations are based on misunderstandings and can be worked out. Having an Ombudsman advocate for you or a loved one can provide peace of mind during an often stressful time.

A full list of Resident’s Rights can be found here. If you are in need of our assistance, please give our office a call at (401) 785-3340 or fill out our contact form here.

– Kathleen Heren
RI State Long-Term Care Ombudsman