Patient Transfer and Discharge, Including Discharge for Cause
Sets out the only reasons for which the Agency transfers or discharges a patient, the written notice the patient receives and when, the Medicare notice of termination and the right to an expedited Quality Improvement Organization review, the Agency’s policy for discharge for cause under 42 CFR §484.50(d)(5), what happens when staff safety is at risk, and the steps after transfer or discharge. Pennsylvania’s home health rules set no discharge notice period; the advance notice for patients who are not Medicare beneficiaries is the Agency’s own standard.
- Policy number
- PA-HH-DC-02
- Version
- 1.0
- Main rule
- 42 CFR §484.50(d)
- Library
- Pennsylvania home health · 56 policies
- Category
- Service delivery
- Sections
- 19
In short
- We transfer or discharge a patient only for one of the seven reasons in the policy, never because they complained.
- Patients get written notice (Form PA-HH-DC-02-A) at least 5 days before the last visit, except in the situations the policy lists.
- Medicare patients also get the Medicare notice at least 2 days before covered services end.
- Discharge for cause needs every step first: tell everyone involved, try to fix the problem, give other agencies’ contacts, document it, and get the Administrator’s approval.
- If you feel unsafe in a home, leave at once, call 911 if needed, and then call your supervisor.
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 (42 CFR §484.50(d))
- 5. Grounds for Transfer or Discharge
- 6. Written Notice to the Patient
- 7. When Shorter Notice Is Given
- 8. Medicare Termination Notice and Expedited Review
- 9. Discharge for Cause
- 10. When Staff Safety Is at Risk
- 11. After Transfer or 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
- Under what circumstances will you discharge a patient? Where do patients learn this?
- Show me the notice this patient received before discharge, and when she received it.
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