§ 2800.228. Transfer and discharge.

 (a)  The facility shall ensure that a transfer or discharge is safe and orderly and that the transfer or discharge is appropriate to meet the resident’s needs. This includes ensuring that a resident is transferred or discharged with all his medications, durable medical equipment and personal property. The residence shall permit the resident to participate in the decision relating to the relocation.

 (b)  If the residence initiates a transfer or discharge of a resident, or if the legal entity chooses to close the residence, the residence shall provide a 30-day advance written notice to the resident, the resident’s family or designated person and the referral agent citing the reasons for the transfer or discharge. This shall be stipulated in the resident-residence contract.

   (1)  The 30-day advance written notice must be written in language in which the resident understands, or performed in American Sign Language or presented orally in a language the resident understands if the resident does not speak standard English. The notice must include the following:

     (i)   The specific reason for the transfer or discharge.

     (ii)   The effective date of the transfer or discharge.

     (iii)   The location to which the resident will be transferred or discharged.

     (iv)   An explanation of the measures the resident or the resident’s designated person can take if they disagree with the residence decision to transfer or discharge which includes the name, mailing address, and telephone number of the State and local long-term care ombudsman.

     (v)   The resident’s transfer or discharge rights, as applicable.

   (2)  Prior to initiating a transfer or discharge of a resident, the residence shall make reasonable accommodation for aging in place that may include services from outside providers. The residence shall demonstrate through support plan modification and documentation the attempts to resolve the reason for the transfer or discharge. Supplemental services may be provided by the resident’s family, residence staff or private duty staff as agreed to by the resident and the residence. This shall be stipulated in the resident-residence contract.

   (3)  Practicable notice, rather than a 30-day advance written notice is required if a delay in transfer or discharge would jeopardize the health, safety or well-being of the resident or others in the residence, as certified by a physician or the Department. This may occur when the resident needs psychiatric services or is abused in the residence, or the Department initiates closure of the residence.

 (c)  A residence shall give the Department written notice of its intent to close the residence, at least 60 days prior to the anticipated date of closing.

 (d)  A residence may not require a resident to leave the residence prior to 30 days following the resident’s receipt of a written notice from the residence regarding the intended closure of the residence, except when the Department determines that removal of the resident at an earlier time is necessary for the protection of the health, safety and well-being of the resident.

 (e)  The date and reason for the transfer or discharge, and the destination of the resident, if known, shall be recorded in the resident record and tracked in a transfer and discharge tracking chart that the residence shall maintain and make available to the Department.

 (f)  If the legal entity chooses to voluntarily close the residence or if the Department has initiated legal action to close the residence, the Department working in conjunction with appropriate local authorities, will offer relocation assistance to the residents. Except in the case of an emergency, each resident may participate in planning the transfer, and shall have the right to choose among the available alternatives after an opportunity to visit the alternative residences. These procedures apply even if the resident is placed in a temporary living situation.

 (g)  Within 30 days of the residence’s closure, the legal entity shall return the license to the Department.

 (h)  The only grounds for transfer or discharge of a resident from a residence are for the following conditions:

   (1)  If a resident is a danger to himself or others and the behavior cannot be managed through interventions, services planning or informed consent agreements.

   (2)  If the legal entity chooses to voluntarily close the residence, or a portion of the residence.

   (3)  If a residence determines that a resident’s functional level has advanced or declined so that the resident’s needs cannot be met in the residence under §  2800.229 (relating to excludable conditions; exceptions) or within the scope of licensure for a residence. In that case, the residence shall notify the resident and the resident’s designated person. The residence shall provide justification for the residence’s determination that the needs of the resident cannot be met. In the event that there is no disagreement related to the transfer or discharge, a plan for other placement shall be made as soon as possible by the administrator in conjunction with the resident and the resident’s designated person, if any. If assistance with relocation is needed, the administrator shall contact appropriate local agencies, such as the area agency on aging, county mental health/intellectual disability program or drug and alcohol program, for assistance. The administrator shall also contact the Department.

   (4)  If meeting the resident’s needs would require a fundamental alteration in the residence’s program or building site, or would create an undue financial or programmatic burden on the residence.

   (5)  If the resident has failed to pay after reasonable documented efforts by the residence to obtain payment.

   (6)  If closure of the residence is initiated by the Department.

   (7)  Documented, repeated violation of the residence rules.

   (8)  A court has ordered the transfer or discharge.

 (i)  If grounds for transfer or discharge is based upon subsection (h)(1) or (3), a certification from one of the following individuals shall be required to certify in writing that the resident can no longer be retained in the residence:

   (1)  The administrator acting in consultation with supplemental health care providers.

   (2)  The resident’s physician or certified registered nurse practitioner.

   (3)  The medical director of the residence.

Authority

   The provisions of this §  2800.228 amended under sections 211 and 213 and Articles IX and X of the Human Services Code (62 P.S. § §  211, 213, 901—922 and 1001—1088).

Source

   The provisions of this §  2800.228 amended June 17, 2016, effective June 18, 2016, 46 Pa.B. 3177. Immediately preceding text appears at serial pages (351550) to (351552).

Cross References

   This section cited in 55 Pa. Code §  2800.25 (relating to resident-residence contract); 55 Pa. Code §  2800.28 (relating to refunds); 55 Pa. Code §  2800.42 (relating to specific rights); and 55 Pa. Code Appendix A (relating to assisted living resident rights: during residency and during discharge or termination of residency).



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