The purpose of this letter is to clarify the difference between transferring and discharging a resident from a NF. The determining factor that differentiates a transfer from a discharge is the assumption of responsibility for a resident’s care and not the resident’s movement.
• Transfer – The releasing facility maintains responsibility for a resident’s care.
• Discharge – The releasing facility ceases to have responsibility for a resident’s care.
This letter also provides federal and state regulations that outline NF responsibilities concerning:
• hospitalization;
• resident relocation;
• a resident’s return to the facility;
• the notice that facilities must provide residents before transfer or discharge;
• the preparation and orientation that a facility must provide residents to ensure a safe and orderly transfer or discharge from the facility;
• discharge planning that must be done by appropriate facility staff; and
• a resident’s right to appeal a transfer or discharge.
Federal Guidelines (Transfer)
The Code of Federal Regulations (CFR), Title 42, §483.12 (F201) guidelines state, “A transfer is moving the resident from the facility to another legally responsible setting…” According to 42 CFR §483.12(a) (F201), “If a resident is living in an institution participating in both Medicare and Medicaid (SNF/NF) under separate provider agreements, a move from either the SNF or NF would constitute a transfer.”
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