{"ref":"MO-HH-DC-02","title":"Transfer and Discharge Notice, Including Discharge for Cause and Medicare Beneficiary Notices","category":"Client rights","summary":"Sets out the only reasons for which the Agency may transfer or discharge a patient under 42 CFR §484.50(d), the written notice given before care is reduced or ended, the Agency's written discharge-for-cause policy with the four steps the rule requires before such a discharge, safe transfer when needs exceed the Agency's capability, and, if the Agency is Medicare-certified, the CMS notices (ABN, HHCCN, NOMNC and DENC) and the expedited determination process through the Quality Improvement Organization.","inShort":["We may discharge a patient only for the reasons in this policy, never because of a complaint.","Give written notice before reducing or ending care.","For Medicare patients, give the NOMNC no later than 2 days before services end, or at the next-to-last visit when visits are more than 2 days apart.","Before any discharge for cause, warn everyone involved, try to fix the problem, give other agencies' contacts and document it all.","If you feel unsafe in a home, leave and call the clinical manager."],"primaryCitation":"42 CFR §484.50(d) (adopted by 19 CSR 30-26.010(1)(A))","citations":["19 CSR 30-26.010(1)(A)","RSMo §192.2475.9","RSMo §197.445.2"],"federalCitations":["42 CFR §484.50(a)(1)(i)","42 CFR §484.50(c)(8)","42 CFR §484.50(c)(11)","42 CFR §484.50(d)","42 CFR §405.1200","42 CFR §405.1202","42 CFR §405.1204","42 CFR §411.408"],"surveyorAsks":["Show me your transfer and discharge policies. How are patients told about them?","Why was this patient discharged? Did the physician agree?"],"forms":[{"ref":"MO-HH-DC-02-A","title":"Notice of Transfer or Discharge"},{"ref":"MO-HH-DC-02-B","title":"Discharge for Cause Documentation Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.50(c)(8), (d); 42 CFR §§405.1200 to 405.1204; 19 CSR 30-26.010(1)(A))","5. Permitted Reasons for Transfer or Discharge","6. Written Notice Before Care Is Reduced or Ended","7. MO HealthNet and Other Patients","8. Medicare Beneficiary Notices (If the Agency Is Medicare-Certified)","9. Expedited Determinations and Financial Liability (Medicare)","10. Discharge for Cause","11. Transfer When Needs Exceed the Agency's Capability","12. When the Agency Ceases to Operate","13. The Patient's Right to Disagree and Complain","14. Responsibilities","15. Records and Compliance Monitoring","16. Staff Training","17. References","18. Related Policies and Forms","19. Approval","20. Revision History"],"version":"1.0","sample":false,"pack":"mo-hha","state":"Missouri","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}