Involuntary Transfers and Discharges

Once a resident is admitted to a long-term care facility, the facility then becomes that person's home. One of the most traumatic things that can happen to a resident is for the facility to attempt to force him to leave this new home against his will. Accordingly, it is important to know under what circumstances a nursing home is allowed to do this and how this action can be challenged. 

Can a Nursing Home Transfer or Discharge a Resident Against His Will? 
Yes. Under certain circumstances, a resident can be transferred or discharged from a nursing home without his consent and against his will. 

Under What Circumstances Can a Nursing Home Involuntarily Transfer or Discharge a Resident? 
Under federal law, a nursing home can involuntarily transfer or discharge a resident only for the following reasons: 

(1) the transfer or discharge is necessary for the resident's welfare and his needs cannot be met by the facility 
(2) the transfer or discharge is appropriate because the resident's health has improved sufficiently so that he no longer needs the services provided by the facility,
(3) the safety of individuals in the facility is endangered 
(4) the health of individuals in the facility would otherwise be endangered
(5) the resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility
(6) the facility ceases to operate 

Does the Resident Have to Be Notified in Advance of an Involuntary Transfer or Discharge? 
Yes. Under federal law, the resident must be notified of the transfer or discharge at least thirty days in advance if he is being discharged because of nonpayment or because the facility is ceasing to operate. The notice may be given as soon as is practicable if the transfer or discharge is required to meet the resident's urgent medical needs, his health improves suff iciently to allow a more immediate transfer or discharge, or the safety or health of individuals in facility would be endangered. The notice may also be given as soon as practicable if the resident has resided in the facility for less than thirty days. 

Does the Notice Have to Be Given in a Particular Manner? 
Yes. The notice must be given to the resident and, if known, a family member or legal representative. The notice must be in writing and in a language and manner the recipient understands. In addition, the notice must include the following information: 

(1) the reason for the transfer or discharge 
(2) the effective date of the transfer or discharge 
(3) the location to which the resident is transferred or discharged 
(4) a statement that the resident has the right to appeal the action to the State 
(5) the name, address, and telephone number of the state long- term care ombudsman 
(6) the mailing address and telephone number of the Advocacy Center for the Elderly and Disabled, if the resident is developmentally disabled or mentally ill 

What Should Be Done if the Nursing Home's Notice of Transfer or Discharge Does Not Meet These Requirements? 
If the nursing home's notice does not contain the required information, the resident or someone acting on his behalf should file a written complaint with the State. The complaint should be filed with the following office: 

For more information on filing complaints, please consult this website's page entitled "How To File A Complaint Against A Nursing Home." 

What Should Be Done If the Resident Wishes to Challenge the Involuntary Transfer or Discharge? 
If the resident wishes to remain in the nursing home, he should file an appeal to challenge the involuntary transfer or discharge. The appeal should be filed in writing with the following office: 

This written notice should also include a request that the Bureau of Appeals notify the nursing home that an appeal has been filed and that the resident is entitled to stay in the facility until the matter is resolved. Once this notice of appeal has been filed, a hearing will be scheduled in which an administrative law judge will decide whether the involuntary transfer or discharge is appropriate. If the resident is dissatisfied with the judge's ruling, he may further challenge the action in a court proceeding. 

When the resident files an appeal, he should also send a copy to the nursing home administrator. This should in itself put the administrator on notice of that an appeal has been filed and that the resident cannot be removed from the facility until the appeal is resolved. 

Because challenges to involuntary transfers or discharges can be complicated, a resident may wish to contact either the state long-term care ombudsman or the Advocacy Center for assistance: 

Does the Resident Have a Right to Remain in Nursing Home While the Appeal is Pending? 
Currently in Louisiana, a resident who files a notice of appeal is automatically allowed to remain in the nursing home until his appeal is resolved. If, however, the nursing home wishes to remove the resident prior to resolution of the appeal, it can contact the Bureau of Appeals for permission to do so. An administrative law judge will then hold an informal hearing to determine whether immediate removal is appropriate. 

What is the Nursing Home's Obligation to Assist With the Transfer or Discharge? 
Under federal law, the facility must provide sufficient preparation and orientation to the resident to ensure safe and orderly transfer or discharge from the facility.

Do These Laws and Regulations Also Apply to Room Changes Within the Same Facility? 
No. The protections discussed in this chapter apply only to transfers or discharges from the facility. If the resident is merely transferred to another bed within the same facility, then these protections are not applicable. Where only a room change is involved, the nursing home need only notify the resident (and, if known, the resident's legal representative or an interested family member) of the change in advance. There is no formal procedure for appealing such a change.