22 Va. Admin. Code § 40-73-430

Current through Register Vol. 41, No. 6, November 4, 2024

Section 22VAC40-73-430 - Discharge of residents

A. The facility shall adopt and conform to a written policy regarding the number of days' notice that is required when a resident wishes to move from the facility. The policy shall not require more than 30 days' notice for a resident-initiated discharge.

B. When actions, circumstances, conditions, care needs, or resident's preferences occur that will result in the discharge of a resident, discharge planning shall begin immediately. The date that discharge planning began shall be documented.

1. The facility shall assist the resident and resident's legal representative, if any, in the discharge or transfer process. The facility shall help the resident prepare for relocation, including discussing the resident's destination.

2. The facility shall notify the resident, the resident's legal representative, and designated contact person, if any, of the reason of the discharge and the plan for the discharge to take place.

3. The facility shall provide written discharge notice to the resident, the resident's legal representative, and contact person, if any, at least 30 days preceding the actual discharge date.

4. The discharge notice shall be dated and include the following:

a. Facility's decision to discharge the resident;

b. Reasons for discharge;

c. Date on which the discharge will occur; and

d. Place the resident will be discharged to.

5. If the discharge timeframe is not met, although persistent efforts have been made, the facility shall document the reason.

C. The assigned staff at the local department of social services and the assessor for public pay residents shall be notified at least 14 days prior to the date that the resident will be discharged.

D. Emergency discharge of residents.

1. The resident's legal representative, designated contact person, family, caseworker, social worker, or any other persons, as appropriate, shall be informed as rapidly as possible of the reason for the move.

2. When an emergency discharge is necessary due to an immediate and serious risk to the health, safety, or welfare of the resident or others, the department's discharge notice form shall be provided as soon as possible, but no later than five days after the emergency discharge. The department's discharge notice form for emergency discharge shall be dated and include the:

a. Facility's decision to discharge the resident;

b. Reasons for discharge;

c. Date on which the discharge will occur;

d. Place the resident will be discharged to; and

e. Information regarding the resident's right to appeal within 30 days from the emergency discharge date. An additional five days is permitted for the resident to appeal to allow time for the assisted living facility to provide the department's discharge notice form pursuant to § 63.2-1805 A 5 of the Code of Virginia.

3. For public pay residents, the assigned staff at the local department of social services and assessor shall be informed as rapidly as possible of the reason to move. The 14-day advance notice of planned discharge described in subsection C of this section does not apply when a resident's condition presents an immediate and serious risk to the health, safety, or welfare to the resident or others, necessitating an emergency discharge.

4. The assisted living facility shall provide a copy of the department's discharge notice form to the regional licensing office and the State Long-Term Care Ombudsman within five days after the emergency discharge.

E. Involuntary discharge of residents may occur under the following circumstances:

1. For nonpayment of contracted charges, provided that the resident has been given at least 30 days to cure the delinquency after notice of such nonpayment was provided to the resident and the resident's legal representative or designated contact person.

2. For the resident's failure to substantially comply with the terms and conditions, as allowed by this chapter, of the resident agreement between the resident and assisted living facility.

3. The facility closes in accordance with regulations.

4. The resident develops a condition or care need that is prohibited pursuant to § 63.2-1805 D of the Code of Virginia and 22VAC40-73-310 H.

5. The assisted living facility has met the following requirements and the facility has made reasonable efforts to meet the needs of the resident:

a. The facility administrator or designated staff member shall ensure that an evaluation of the individual is or has been conducted by a qualified mental health professional as defined in 22VAC40-73-10 if there are observed behaviors or patterns of behavior indicative of mental illness, intellectual disability, substance abuse, or behavioral disorders, as documented in the uniform assessment instrument completed pursuant to § 63.2-1804 of the Code of Virginia.

b. If the evaluation indicates a need for mental health, developmental, substance abuse, or behavioral disorder services, the facility shall provide a notification of the resident's need for such services to the designated contact person of record when available and a notification of the resident's need for such services to the community services board or behavioral health authority established pursuant to Title 37.2 of the Code of Virginia that serves the city or county in which the facility is located or other appropriate licensed provider.

c. Unless an emergency discharge is necessary due to an immediate and serious risk to the health, safety, or welfare of the resident or others, the facility shall, prior to involuntarily discharge of a resident, make reasonable efforts, as appropriate, to resolve any issues with the resident upon which the decision to discharge is based. The decision and such efforts shall be documented in the resident's file.

d. The department shall not take adverse action against a facility that has demonstrated and documented a continual good faith effort to meet the requirements of this subsection.

6. The department's discharge notice form for involuntary discharges shall include all requirements of subdivisions B 3 and B 4 of this section and shall include information regarding the resident's right to appeal within the 30-day notice period.

7. The assisted living facility shall provide a copy of the department's discharge notice form to the regional licensing office and the State Long-Term Care Ombudsman at least 30 days prior to an involuntary discharge.

F. For public pay residents, in the event of a resident's death, the assisted living facility shall provide written notification to the assigned staff at the local department of social services and assessor within five days after the resident's death.

G. Discharge statement.

1. At the time of discharge, the assisted living facility shall provide to the resident and, as appropriate, the resident's legal representative and designated contact person a dated statement signed by the licensee or administrator that contains the following information:

a. The date on which the resident, the resident's legal representative, or designated contact person was notified of the planned discharge and the name of the legal representative or designated contact person who was notified;

b. The reason for the discharge;

c. The actions taken by the facility to assist the resident in the discharge and relocation process; and

d. The date of the actual discharge from the facility and the resident's destination.

2. A copy of the discharge statement shall be retained in the resident's record.

H. When the resident is discharged and moves to another caregiving facility, the assisted living facility shall provide to the receiving facility such information related to the resident as is necessary to ensure continuity of care and services. Original information pertaining to the resident shall be maintained by the assisted living facility from which the resident was discharged. The assisted living facility shall maintain a listing of all information shared with the receiving facility.

I. Within 60 days of the date of discharge, each resident or resident's legal representative shall be given a final statement of account, any refunds due, and return of any money, property, or things of value held in trust or custody by the facility.

22 Va. Admin. Code § 40-73-430

Derived From Virginia Register Volume 34, Issue 6, eff. February 1, 2018; Amended, Virginia Register Volume 40, Issue 1, eff. 11/27/2023.

Statutory Authority: §§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.