Section 390.3300 Transfer or Discharge

Section 390

Section 390.3300  Transfer or

Discharge

a)

A resident may be discharged from a facility after giving

the administrator, a physician, or a nurse of the facility written notice of the

resident's desire to be discharged. If a guardian has been appointed for a

resident or if the resident is a minor, the resident shall be discharged upon

written consent of the guardian, or if the resident is a minor, a parent,

unless there is a court order to the contrary. In such cases, upon the

resident's discharge, the facility is relieved from any responsibility for the

resident's care, safety or well-being.

(Section 2-111 of the Act)

b)         Each resident's rights regarding involuntary transfer or

discharge from a facility shall be as described in subsections (c) through (y).

c)         Reasons for Transfer or Discharge

1)

A facility may involuntarily transfer or discharge a

resident only for one or more of the following reasons:

A)

For medical reasons

.

B)

For the resident's physical safety

.

C)

For the physical safety of other residents, the facility

staff or facility visitors

.

D)

For either late payment or nonpayment for the resident's

stay, except as prohibited by Title XVIII and XIX of the Federal Social

Security Act. For purposes of this Section, "late payment" means

non-receipt of payment after submission of a bill. If payment is not received

within 45 days after submission of a bill, the facility may send a notice to

the resident and responsible party requesting payment within 30 days. If

payment is not received within such 30 days, the facility may thereupon

institute transfer or discharge proceedings by sending a notice of transfer or

discharge to the resident and responsible party by registered or certified

mail

not received

within 45 days after submission of a bill, the facility may send a notice to

the resident and responsible party requesting payment within 30 days. If

payment is not received within such 30 days, the facility may thereupon

institute transfer or discharge proceedings by sending a notice of transfer or

discharge to the resident and responsible party by registered or certified

mail. The notice shall state, in addition to the requirements of Section 3-403

of the Act

and subsection (e),

that the responsible party has the right

to pay the amount of the bill in full up to the date the transfer or discharge

is to be made and then the resident shall have the right to remain in the

facility.

An in-full payment

shall terminate the transfer or discharge

proceedings. This

subsection

does not apply to those residents whose

care is provided under the Illinois Public Aid Code

. (B) (Section 3-401 of

the Act)

2)         Prohibition of Discrimination

A)

A facility participating in the Medical Assistance Program

is prohibited from failing or refusing to retain as a resident any person

because the resident is a recipient of or an applicant for the Medical

Assistance Program. For the purposes of this

Section

, a recipient or

applicant shall be considered a resident in the facility during any hospital

stay totaling ten days or less following a hospital admission.

(Section

3-401.1(a-10) of the Act) The day on which a resident is discharged from the

facility and admitted to the hospital shall be considered the first day of the

ten-day period.

B)

A facility which violates

this Section

shall be

guilty of a business offense and fined not less than $500 nor more than $1,000

for the first offense and not less than $1,000 nor more than $5,000 for each

subsequent offense

401.1(a-10) of the Act) The day on which a resident is discharged from the

facility and admitted to the hospital shall be considered the first day of the

ten-day period.

B)

A facility which violates

this Section

shall be

guilty of a business offense and fined not less than $500 nor more than $1,000

for the first offense and not less than $1,000 nor more than $5,000 for each

subsequent offense.

(Section 3-401.1(b) of the Act)

C)

A facility of which only a distinct part is certified to

participate in the Medical Assistance Program may refuse to retain as a

resident any person who resides in a part of the facility that does not

participate in the Medical Assistance Program and who is unable to pay for his

or her care in the facility without Medical Assistance only if:

1)

The facility, no later than at the time of admission and at

the time of the resident's contract renewal, explains to the resident (unless the

resident is incompetent), and to the resident's representative, and to the

person making payment on behalf of the resident for the resident's stay, in

writing, that the facility may discharge the resident if the resident is no

longer able to pay for care in the facility without Medical Assistance; and

2)

The resident (unless incompetent), the resident's

representative, and the person making payment on behalf of the resident for the

resident's stay, acknowledge in writing that they have received the written

explanation

he resident's stay, in

writing, that the facility may discharge the resident if the resident is no

longer able to pay for care in the facility without Medical Assistance; and

2)

The resident (unless incompetent), the resident's

representative, and the person making payment on behalf of the resident for the

resident's stay, acknowledge in writing that they have received the written

explanation.

(Section 3-401.1(a-5) of the Act)

d)

Involuntary transfer or discharge of a resident from a

facility shall be preceded by the discussion required under

subsection (j)

and by a minimum written notice of 21 days, except in one of the following

instances:

1)

When an emergency transfer or discharge is ordered by the

resident's attending physician because of the resident's health care needs

(Section

3-402(a) of the Act); or

2)

When the transfer or discharge is mandated by the physical

safety of other residents, the facility staff, or facility visitors, as documented

in the clinical record.

The Department

will

immediately offer

transfer, or discharge and relocation assistance to residents transferred or

discharged under this

subsection

and may place relocation teams as

provided in Section 3-419 of

the

Act.

(Section 3-402(b) of the Act)

e)

The notice required by

subsection (d)

shall be on a

form prescribed by the Department and shall contain all of the following:

1)

The stated reason for the proposed transfer or discharge;

(Section 3-403(a) of the Act)

2)

The effective date of the proposed transfer or discharge;

(Section 3-403(b) of the Act)

3)

A statement in not less than 12-point type, which reads:

"You

have a right to appeal the facility's decision to transfer or discharge you. If

you think you should not have to leave this facility, you may file a request

for a hearing with the Department of Public Health within 10 days after

receiving this notice. If you request a hearing, it will be held not later than

10 days after your request, and you generally will not be transferred or

discharged during that time

o appeal the facility's decision to transfer or discharge you. If

you think you should not have to leave this facility, you may file a request

for a hearing with the Department of Public Health within 10 days after

receiving this notice. If you request a hearing, it will be held not later than

10 days after your request, and you generally will not be transferred or

discharged during that time. If the decision following the hearing is not in

your favor, you generally will not be transferred or discharged prior to the expiration

of 30 days following receipt of the original notice of the transfer or discharge.

A form to appeal the facility's decision and to request a hearing is attached. If

you have any questions, call the Department of Public Health at the telephone

number listed below."

(Section 3-403(c) of the Act)

4)

A hearing request form, together with a postage paid,

preaddressed envelope to the Department; and

(Section 3-403(d) of the Act)

5)

The name, address, and telephone number of the person

charged with the responsibility of supervising the transfer or discharge.

(Section 3-403(e) of the Act)

f)

A request for a hearing made under

subsection (e)

shall stay a transfer pending a hearing or appeal of the decision, unless a

condition which would have allowed transfer or discharge in less than 21 days as

described under

subsections (d)(1) and (2)

develops in the interim.

(Section

3-404 of the Act)

g)

A copy of the notice required by

subsection (d)

shall be placed in the resident's clinical record and a copy shall be

transmitted to the Department, the resident, and the resident's representative

e decision, unless a

condition which would have allowed transfer or discharge in less than 21 days as

described under

subsections (d)(1) and (2)

develops in the interim.

(Section

3-404 of the Act)

g)

A copy of the notice required by

subsection (d)

shall be placed in the resident's clinical record and a copy shall be

transmitted to the Department, the resident, and the resident's representative.

(Section 3-405 of the Act)

h)

When the basis for an involuntary transfer or discharge is

the result of an action by the Department of Healthcare and Family Services

with respect to a recipient of Title XIX of the Social Security Act and a

hearing request is filed with the Department of Healthcare and Family Services,

the 21-day written notice period shall not begin until a final decision in the

matter is rendered by the Department of Healthcare and Family Services or a

court of competent jurisdiction and notice of that final decision is received

by the resident and the facility.

(Section 3-406 of the Act)

i)

When nonpayment is the basis for involuntary transfer or

discharge, the resident shall have the right to redeem up to the date that the

discharge or transfer is to be made and then shall have the right to remain in

the facility.

(Section 3-407 of the Act)

j)

The planned involuntary transfer or discharge shall be

discussed with the resident, the resident's representative and person or agency

responsible for the resident's placement, maintenance, and care in the

facility. The explanation and discussion of the reasons for involuntary

transfer or discharge shall include the facility administrator or other

appropriate facility representative as the administrator's designee. The

content of the discussion and explanation shall be summarized in writing and

shall include the names of the individuals involved in the discussions and made

a part of the resident's clinical record

nation and discussion of the reasons for involuntary

transfer or discharge shall include the facility administrator or other

appropriate facility representative as the administrator's designee. The

content of the discussion and explanation shall be summarized in writing and

shall include the names of the individuals involved in the discussions and made

a part of the resident's clinical record.

(Section 3-408 of the Act)

k)

The facility shall offer the resident counseling services before

the transfer or discharge of the resident.

(Section 3-409 of the Act)

l)

A resident subject to involuntary transfer or discharge

from a facility, the resident's guardian, or if the resident is a minor, his or

her parent, shall have the opportunity to file a request for a hearing with the

Department within 10 days following receipt of the written notice of the

involuntary transfer or discharge by the facility.

(Section 3-410 of the

Act)

m)

The Department of Public Health, when the basis for involuntary

transfer or discharge is other than action by the Department of Healthcare and

Family Services with respect to the Title XIX Medicaid recipient, shall hold a

hearing at the resident's facility not later than 10 days after a hearing

request is filed, and render a decision within 14 days after the filing of the

hearing request.

(Section 3-411 of the Act)

n)

The hearing before the Department provided under

subsection

is other than action by the Department of Healthcare and

Family Services with respect to the Title XIX Medicaid recipient, shall hold a

hearing at the resident's facility not later than 10 days after a hearing

request is filed, and render a decision within 14 days after the filing of the

hearing request.

(Section 3-411 of the Act)

n)

The hearing before the Department provided under

subsection

(m)

shall be conducted as prescribed under Section 3-703 of the Act. In

determining whether a transfer or discharge is authorized, the burden of proof

in this hearing rests on the person requesting the transfer or discharge.

(Section

3-412 of the Act)

o)

If the Department determines that a transfer or discharge

is authorized under

subsection (c)

, the resident shall not be required

to leave the facility before the 34

th

day following receipt of the

notice required under

subsection (d)

, or the 10

th

day

following receipt of the Department's decision, whichever is later, unless a

condition which would have allowed transfer or discharge in less than 21 days as

described under

subsections (d)(1) and (2)

develops in the interim.

(Section

3-413 of the Act)

p)

The Department of Healthcare and Family Services shall

continue Title XIX Medicaid funding during the appeal, transfer, or discharge

period for those residents who are recipients of assistance under Title XIX of

the Social Security Act affected by

subsection (c)

.

(Section 3-414

of the Act)

q)

The Department may transfer or discharge any resident from

any facility required to be licensed under this Act when any of the following

conditions exist:

1)         The

facility is operating without a license;

(Section

3-415(a) of the Act)

2)

The Department has suspended, revoked or refused to renew

the license of the facility as provided under Section 3-119 of the Act

n 3-414

of the Act)

q)

The Department may transfer or discharge any resident from

any facility required to be licensed under this Act when any of the following

conditions exist:

1)         The

facility is operating without a license;

(Section

3-415(a) of the Act)

2)

The Department has suspended, revoked or refused to renew

the license of the facility as provided under Section 3-119 of the Act.

(Section 3-415(b) of the Act)

3)

The facility has requested the aid of the Department in the

transfer or discharge of the resident and the Department finds that the

resident consents to transfer or discharge;

(Section 3-415(c) of the Act)

4)

The facility is closing or intends to close and adequate

arrangement for relocation of the resident has not been made at least 30 days

prior to closure; or

(Section 3-415(d) of the Act)

5)

The Department determines that an emergency exists which

requires immediate transfer or discharge of the resident.

(Section 3-415(e)

of the Act)

r)

In deciding to transfer or discharge a resident from a

facility under

subsection (q)

, the Department shall consider the

likelihood of serious harm which may result if the resident remains in the facility.

(Section 3-416 of the Act)

s)

The Department shall offer transfer or discharge and

relocation assistance to residents transferred or discharged under

subsections

(c) through (q)

including information on available alternative placements. Residents

shall be involved in planning the transfer or discharge and shall choose among

the available alternative placements, except that where an emergency makes

prior resident involvement impossible, the Department may make a temporary

placement until a final placement can be arranged. Residents may choose their

final alternative placement and shall be given assistance in transferring to

the

alternative placement

. No resident may be forced to remain in a temporary or

permanent placement

le alternative placements, except that where an emergency makes

prior resident involvement impossible, the Department may make a temporary

placement until a final placement can be arranged. Residents may choose their

final alternative placement and shall be given assistance in transferring to

the

alternative placement

. No resident may be forced to remain in a temporary or

permanent placement. Where the Department makes or participates in making the

relocation decision, consideration shall be given to proximity to the

resident's relatives and friends. The resident shall be allowed three visits to

potential alternative placements prior to removal, except where medically contraindicated

or where the need for immediate transfer or discharge requires reduction in the

number of visits.

(Section 3-417 of the Act)

t)

The Department shall prepare resident transfer or

discharge plans to assure safe and orderly removals and protect residents' health,

safety, welfare and rights. In nonemergencies and where possible in

emergencies, the Department shall design and implement such plans in advance of

transfer or discharge.

(Section 3-418 of the Act)

u)

The Department may place relocation teams in any facility

from which residents are being discharged or transferred for any reason, for

the purpose of implementing transfer or discharge plans.

(Section 3-419 of

the Act)

v)

In any transfer or discharge conducted under

subsections

Department shall design and implement such plans in advance of

transfer or discharge.

(Section 3-418 of the Act)

u)

The Department may place relocation teams in any facility

from which residents are being discharged or transferred for any reason, for

the purpose of implementing transfer or discharge plans.

(Section 3-419 of

the Act)

v)

In any transfer or discharge conducted under

subsections

(q) through (t)

the Department

will

:

1)

Provide written notice to the facility prior to the

transfer or discharge. The notice shall state the basis for the order of

transfer or discharge and shall inform the facility of its right to an informal

conference prior to transfer or discharge under this

Section

, and its

right to a subsequent hearing under

subsection (x)

. If a facility

desires to contest a nonemergency transfer or discharge, prior to transfer or

discharge it shall, within 4 working days after receipt of the notice, send a

written request for an informal conference to the Department. The Department

shall, within 4 working days from the receipt of the request, hold an informal conference

in the county in which the facility is located. Following this conference, the

Department may affirm, modify or overrule its previous decision. Except in an

emergency, transfer or discharge may not begin until the period for requesting

a conference has passed or, if a conference is requested, until after a conference

has been held; and

(Section 3-420(a) of the Act)

2)

Provide written notice to any resident to be removed, to

the resident's representative, if any, and to a member of the resident's

family, where practicable, prior to the removal. The notice shall state the

reason for which transfer or discharge is ordered and shall inform the resident

of the resident's right to challenge the transfer or discharge under

subsection

ction 3-420(a) of the Act)

2)

Provide written notice to any resident to be removed, to

the resident's representative, if any, and to a member of the resident's

family, where practicable, prior to the removal. The notice shall state the

reason for which transfer or discharge is ordered and shall inform the resident

of the resident's right to challenge the transfer or discharge under

subsection

(x)

. The Department shall hold an informal conference with the resident or

the resident's representative prior to transfer or discharge at which the

resident or the representative may present any objections to the proposed

transfer or discharge plan or alternative placement.

(Section 3-420(b) of

the Act)

w)

In any transfer or discharge conducted under

subsection

(q)(5)

, the Department shall notify the facility and any resident to be

removed that an emergency has been found to exist and removal has been ordered,

and shall involve the residents in removal planning if possible. Following

emergency removal, the Department shall provide written notice to the facility,

to the resident, to the resident's representative, if any, and to a member of

the resident's family, where practicable, of the basis for the finding that an

emergency existed and of the right to challenge removal under

subsection

(x)

.

(Section 3-421 of the Act)

x)

Within 10 days following transfer or discharge, the

facility or any resident transferred or discharged may send a written request

to the Department for a hearing under Section 3-703 of the Act to challenge the

transfer or discharge. The Department shall hold the hearing within 30 days of receipt

of the request. The hearing shall be held at the facility from which the

resident is being transferred or discharged, unless the resident or resident's

representative, requests an alternative hearing site. If the facility prevails,

it may file a claim against the State under the Court of Claims Act for

payments lost less expenses saved as a result of the transfer or discharge

days of receipt

of the request. The hearing shall be held at the facility from which the

resident is being transferred or discharged, unless the resident or resident's

representative, requests an alternative hearing site. If the facility prevails,

it may file a claim against the State under the Court of Claims Act for

payments lost less expenses saved as a result of the transfer or discharge. No

resident transferred or discharged may be held liable for the charge for care

which would have been made had the resident remained in the facility. If a

resident prevails, the resident may file a claim against the State under the

Court of Claims Act for any excess expenses directly caused by the order to

transfer or discharge. The Department shall assist the resident in returning to

the facility if assistance is requested.

(Section 3-422 of the Act)

y)

Any owner of a facility licensed under this Act shall give

90 days' notice prior to voluntarily closing a facility or closing any part of

a facility or prior to closing any part of a facility if closing such part will

require the transfer or discharge of more than 10% of the residents. Such

notice shall be given to the Department, to any resident who must be

transferred or discharged, to the resident's representative, and to a member of

the resident's family, where practicable. Notice shall state the proposed date

of closing and the reason for closing. The facility shall offer to assist the

resident in securing an alternative placement and shall advise the resident on

available alternatives. Where the resident is unable to choose an alternate

placement and is not under guardianship, the Department shall be notified of

the need for relocation assistance. The facility shall comply with all

applicable laws and regulations until the date of closing, including those

related to transfer or discharge of residents. The Department may place a

relocation team in the facility as provided under

subsection (u). (Section

3-423 of the Act)