NORC Library

New Resource - Enhancing Your Advocacy Toolbox: Protecting Residents from Nursing Facility-Initiated Discharges

January 13th, 2021

Complaints regarding nursing facility-initiated discharges have been the most common type of complaint received by the Long-Term Care Ombudsman program for the last nine years.

According to federal guidance for surveyors, “facility-initiated discharge” is defined as “a transfer or discharge which the resident objects to, did not originate through a resident’s verbal or written request, and/or is not in alignment with the resident’s stated goals for care and preferences.” 

To assist Ombudsman programs when working with residents facing a facility-initiated discharge, the National Ombudsman Resource Center produced a new resource titled, Enhancing Your Advocacy Toolbox: Protecting Residents from Nursing Facility-Initiated Discharges.

This resource blends pertinent federal nursing home requirements and surveyor guidance with action steps for Ombudsmen to consider. We encourage Ombudsman programs to use this resource as a basic guide for using federal regulations and guidance to address common issues related to facility-initiated discharges.

 Charts with resolution strategies, action steps, and the legal basis to address common discharge reasons

• Basic Discharge Complaint Investigation Process Checklist
• Common Discharge Reasons
  • Reason 1: The discharge or transfer is necessary for the resident’s welfare and the facility cannot meet the resident’s needs.
  • Reason 2: The resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility.
  • Reason 3: The resident’s clinical or behavioral status (or condition) endangers the safety of individuals in the facility.
  • Reason 4: The resident’s clinical or behavioral status (or condition) otherwise endangers the health of individuals in the facility.
  • Reason 5: The resident has failed to pay for (or to have paid under Medicare or Medicaid) his or her stay at the facility.