CMS published S & C Memo 17-27-NH back in May of 2017. The Memo provided additional guidance on when and how it is necessary to provide notice to the State Ombudsman. There seems to be continued confusion from providers.
– A facility must give notice to the resident, the resident representative and the State Ombudsman for all facility-initiated transfers and discharges, including a transfer to the hospital.
– A facility-initiated transfer or discharge is defined as all moves in which a resident’s medical record does not clearly document the residents or resident representatives verbal or written notice of intent to leave the facility or more clearly a planned discharge or one that could be predicted with planning has not been developed.
In short, a notice to the State Ombudsman is required for all facility-initiated transfers. The time you must provide the notice depends on individual circumstances but always as soon as practical.
Examples:
– A facility transfers a resident to the hospital for an emergency with intent to re-admit the resident.
– The facility must provide notice to the resident, resident representative as soon as practicable.
– The facility can group notices for an emergency-initiated transfer to the hospital when the intent is to re-admit the resident upon discharge from the hospital or emergency department care.
– A facility transfers a resident to the hospital for an emergency with intent to re-admit the resident however decides to initiate a facility discharge instead.
– A 30-day notice to the resident, resident representative and to the Ombudsman is required.
– The initial notice might have been grouped and sent to the ombudsman however this is no longer accurate because the facility-initiated transfer for an emergency to the hospital with the intent to re-admit has now become a facility-initiated discharge without an intent to re-admit.
– Always keep documentation for your records and clearly identify your facility information when batching notices to the State Ombudsman. Please note, the State Ombudsman is to be notified and not the local ombudsman.
If you have questions email ldavenport@ihca.org or call 765-516-0148 and speak to Lori Davenport.