Reduction, Termination, Transfer, and Discharge Notice, Including Discharge for Cause
Allows the Agency to transfer or discharge a patient only on the grounds 42 CFR §484.50(d) permits, and requires at least 48 hours’ advance notice to the patient or responsible party before any reduction or termination of service (North Carolina’s three exceptions only), the Medicare termination notice no later than 2 days before covered services end, notice to the physician, coordination of other care, and, for a discharge for cause, a written policy, warning, attempts to resolve the problem, contacts for other providers, and full documentation.
- Policy number
- NC-HH-DC-02
- Version
- 1.0
- Main rule
- 10A NCAC 13J .1101(7)
- Library
- North Carolina home health · 57 policies
- Category
- Client rights
- Sections
- 19
In short
- We reduce or end services only for a reason the law allows.
- Give the patient written notice at least 48 hours before any reduction or end of service, unless the patient agrees, there is danger, or the doctor ended services.
- Medicare patients also get the Medicare notice at least 2 days before covered services end; it explains the fast appeal.
- Never discharge a patient for complaining. Discharge for cause needs warnings, efforts to fix the problem and the director’s approval.
- If you are in danger, leave the home, call the supervising nurse, and call 911 if needed.
What's inside
19 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (10A NCAC 13J .1101(7); 42 CFR §484.50(d))
- 5. Permitted Grounds for Transfer or Discharge
- 6. The Decision
- 7. North Carolina 48-Hour Notice
- 8. Medicare Notices
- 9. Discharge for Cause
- 10. When There Is a Danger to the Patient or Staff
- 11. Coordinating Other Care
- 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
- Show me the notice you gave this patient before you reduced the aide visits. When did the patient receive it?
- When may you discharge without 48 hours’ notice?
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