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Termination of Services, Transfer and Discharge Notice, and Discharge for Cause

States the reasons for which the Agency terminates services (22 CCR §74721(c)(3)), which also form its transfer and discharge policy for patients (42 CFR §484.50(a)(1)(i), (d)); how and when the patient is told in writing in advance (Agency standard, since California sets no home health discharge notice period); the Notice of Medicare Non-Coverage at least 2 days before Medicare-covered services end and the patient’s right to a fast QIO appeal (42 CFR §§405.1200-405.1202); the steps the Agency must take before discharging a patient for cause (§484.50(d)(5)); and the discharge statement (22 CCR §74735(a)(9)).

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About this policy
Policy number
CA-HH-DC-02
Version
1.0
Main rule
22 CCR §74721(c)(3)
Library
California home health · 58 policies
Category
Service delivery
Sections
19

In short

  • We end a patient’s services only for the reasons in Table 1. Never threaten a patient with discharge.
  • Patients get written notice at least 5 days before a planned discharge, unless it is an emergency or the patient asks to stop.
  • Medicare patients get the Notice of Medicare Non-Coverage at least 2 days before covered services end, and must sign it.
  • Before a discharge for cause, we tell the patient and doctors, try to fix the problem, give names of other providers, and write it all down.
  • If you are in danger during a visit, leave, call 911 if needed, and call your supervisor.

What's inside

19 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (22 CCR §74721(c)(3))
  • 5. Reasons for Termination of Services
  • 6. When Advance Notice Is Not Possible
  • 7. The Written Notice
  • 8. Medicare Notices and Fast Appeals
  • 9. Discharge for Cause
  • 10. Immediate Threat to Safety
  • 11. At Discharge
  • 12. Responsibilities
  • 13. Records and Compliance Monitoring
  • 14. Staff Training
  • 15. References
  • 16. Related Policies and Forms
  • 17. Approval
  • 18. Revision History

An inspector may ask

  • What are your written reasons for termination of services?
  • Show me the notice you gave this patient before discharge, and when it was given.

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