One of the most frequent issues I face revolves around the discharge of a resident from a nursing home. Often times, an agent or advocate visits my office with a concern, because their loved one is being discharged from the nursing home, and they want to assess what their options are. The good news is that the nursing home cannot just kick a resident out of the nursing home.
A common discharge is related to a loss of Medicare coverage for rehab or skilled nursing care. Under Medicare rules, coverage of rehab services will not extend beyond day 100 and will be cut short due to a refusal to participate in therapies or if daily skilled care is no longer necessary. However, what most facilities fail to explain to the residents and their advocates is that they have the option to remain in the facility, and the nursing home may only involuntarily discharge under a set of parameters as set forth under the Nursing Home Reform Act. Specifically, a nursing home must allow a resident to remain in the facility unless one of the following conditions is met:
And, even under those circumstances, the facility is still responsible for the development of a safe-discharge plan. Specifically, a facility is responsible for developing a post-discharge care plan that assesses the continuing care needs and development of a plan designed to ensure the individual’s needs will be met after discharge from the facility into the community.
All too frequently, we receive a statement from a discharge planner that the “safe-discharge plan” includes going to an assisted living facility or returning home with private duty staff to assist with 24/7 care. The problem; however, is that the resident may not be able to afford either of those options, and as a result, would not be safe alternatives to the nursing home. Not only has the nursing facility not informed the resident of his or her right to remain at the facility under private pay (or that Medicaid may be able to assist with paying for care), but has failed to consider whether the “safe-discharge plan” is a viable option.
The question then becomes what is the motivation to discharge a patient. It is simple– the nursing home is a business. Most nursing homes prefer Medicare reimbursement or private pay over Medicaid reimbursement to protect the financial stake of the company. Furthermore, most nursing homes prefer residents who do not have extraneous care needs or advocates that are determined to present a problem to a nursing home.
So, you are probably wondering what you can do in light of an improper discharge:
Seek an experienced advocate. If you feel something isn’t right, you should seek someone experienced with resident rights.
Ask Kit Kat – Helping Feral Cats
Hook Law Center: Kit Kat, what can someone do to help feral cats which may be living in a neighborhood?
Kit Kat: Well, there are some things which can be done, but you will need help from your community. At least, that is what is suggested in a recent article in the All Animals magazine published by the Humane Society of the United States (HSUS). In that article, it is suggested that the person spearheading the effort must first talk to their neighbors and get their input. If one person just captures a few cats with traps, there may be many more out there who will continue breeding, and the situation will not become manageable. Let me provide an example, so you will see what I mean.
Beth McNulty, an operations manager with the HSUS, who lives in rural Monrovia, MD noticed in 2010 a spike in the number of stray cats which were wandering through her yard. Occasionally, she would see one or two, but this was almost a dozen. She herself had 3 indoor cats, and one was just recovering from a spraying behavior, so she was afraid to take in anymore cats would set hers off again. In her sleuthing, she discovered that the cats had been living in a nearby junkyard which was being cleaned out. The cats fled in the confusion. To make a long story short, she discovered that the best way to start the process of helping the feral cat colony was to involve her neighbors. Their awareness and help resulted in a neighborhood-wide trapping effort. Thirty older cats and older kittens were sterilized, and returned to their former abode (the now clean junkyard). Three small kittens were placed with a rescue group. McNulty hasn’t seen another addition to the clan yet. This approach of capturing feral cats, sterilizing them, and returning them to live on their own is known as TNR (trap-neuter-return). It appears to be a humane way of caring for them without resorting to euthanasia.
You can tell if a feral cat has been sterilized by a clipped ear lobe. That is done after the sterilization, so all will know. How can you tell the difference between someone’s pet who has just gotten lost or a feral cat? Usually, the feral cat will not eat in the presence of a human. The feral cat will only eat after the human has walked away. So, be aware of stray cats in your community. There may be a way to humanely maintain them there, as they live out their lives.(Julie Falconer, “The Outsiders-How to Help your Neighborhood’s Felines,” All Animals, July/August 2016, p. 16-21)
Distribution of This Newsletter
Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Understanding a Resident’s Transfer and Discharge Rights under the Nursing Home Reform Act first appeared on SEONewsWire.net.]]>