Minnesota Nursing Home Abuse and Neglect Lawyer Kenneth LaBore 1-888-452-6589

Resident Assessment Required by Federal Law

Nursing Homes Must Conduct Regular Comprehensive Assessment of Needs and Risks

Nursing Homes Must Conduct Regular Comprehensive Assessment of Needs and Risks

Nursing Home Must Make Comprehensive Assessment of Residents Needs

Pursuant to 42 CFR § 483.20, the facility must conduct initially and periodically a comprehensive, accurate, standardized, reproducible assessments of each resident’s functional capacity.

(a) Admission orders. At the time each resident is admitted, the facility must have physician orders for the resident’s immediate care.

(b) Comprehensive assessments—(1) Resident assessment instrument. A facility must make a comprehensive assessment of a resident’s needs, strengths, goals, life history and preferences, using the resident assessment instrument (RAI) specified by CMS.

Resident Assessment Must Include Key Issues of Resident Risks and Needs

The assessment must include at least the following:

(i) Identification and demographic information.
(ii) Customary routine.
(iii) Cognitive patterns.
(iv) Communication.
(v) Vision.
(vi) Mood and behavior patterns.
(vii) Psychosocial well-being.
(viii) Physical functioning and structural problems.
(ix) Continence.
(x) Disease diagnoses and health conditions.
(xi) Dental and nutritional status.
(xii) Skin condition.
(xiii) Activity pursuit.
(xiv) Medications.
(xv) Special treatments and procedures.
(xvi) Discharge planning.
(xvii) Documentation of summary information regarding the additional assessment performed on the care areas triggered by the completion of the Minimum Data Set (MDS).
(xviii) Documentation of participation in assessment. The assessment process must include direct observation and communication with the resident, as well as communication with licensed and nonlicensed direct care staff members on all shifts.

The failure of facilities to evaluate the risks and needs of residents leads to many types of elder abuse and neglect including falls, pressure sores, medication errors, sexual assault and others.

Unlike many other types of injury claims, there are standards and regulations, both state and federal for most care provided in a nursing home, which apply to all facilities which accept Medicare and Medicaid residents. Pursuant to Minnesota Rule 4658.0015 a nursing home must “operate and provide services in compliance with all applicable federal, state, and local laws, regulations, and codes, and with accepted professional standards and principles that apply to professionals providing services in a nursing home.”

Most cases are a result of some combination of short staffing, poor training, lack of medical supplies and equipment and a failure to follow care plans and to regularly assess residents especially when there has been a change of condition, including medical conditions and accidents/incidents. The failure to respond to changes in condition in a timely manner leads to many serious injuries such as amputations and often times death. Injuries and death due to the lack of proper supervision and assessment are truly preventable and the type of situations that could be improved with a movement towards holding facilities accountable.

KLaBore@MNnursinghomeneglect.com

Please contact elder abuse and neglect Attorney Kenneth LaBore with any questions you may have at 612-743-9048.

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Bed Hold Policies in Nursing Homes

Bed Hold Regulations in Nursing Homes

Bed Hold Regulations in Nursing Homes

Federal Bed Hold Policies for Nursing Homes

Pursuant to federal regulation contained in 42 CFR 483.15(d),  Notice of bed-hold policy and return—(1) Notice before transfer. Before a nursing facility transfers a resident to a hospital or the resident goes on therapeutic leave, the nursing facility must provide written information to the resident or resident representative that specifies—

(i) The duration of the state bed-hold policy, if any, during which the resident is permitted to return and resume residence in the nursing facility;

(ii) The reserve bed payment policy in the state plan, under §447.40 of this chapter, if any;

(iii) The nursing facility’s policies regarding bed-hold periods, which must be consistent with paragraph (c)(3) of this section, permitting a resident to return; and

(iv) The information specified in paragraph (c)(3) of this section.

More Information About Federal Nursing Home Bed Hold Regulations

(2) Bed-hold notice upon transfer. At the time of transfer of a resident for hospitalization or therapeutic leave, a nursing facility must provide to the resident and the resident representative written notice which specifies the duration of the bed-hold policy described in paragraph (c)(1) of this section.
(e)(1) Permitting residents to return to facility. A facility must establish and follow a written policy on permitting residents to return to the facility after they are hospitalized or placed on therapeutic leave. The policy must provide for the following.

(i) A resident, whose hospitalization or therapeutic leave exceeds the bed-hold period under the State plan, returns to the facility to their previous room if available or immediately upon the first availability of a bed in a semi-private room if the resident

(A) Requires the services provided by the facility; and
(B) Is eligible for Medicare skilled nursing facility services or Medicaid nursing facility services.

(ii) If the facility that determines that a resident who was transferred with an expectation of returning to the facility cannot return to the facility, the facility must comply with the requirements of paragraph (c) as they apply to discharges.

(2) Readmission to a composite distinct part. When the facility to which a resident returns is a composite distinct part (as defined in §483.5), the resident must be permitted to return to an available bed in the particular location of the composite distinct part in which he or she resided previously. If a bed is not available in that location at the time of return, the resident must be given the option to return to that location upon the first availability of a bed there.

KLaBore@MNnursinghomeneglect.com
Please contact elder abuse and neglect Attorney Kenneth LaBore with any questions you may have at 612-743-9048.

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Nursing Home Discharge and Transfer Notice Requirments

Nursing Home Discharge Notice Requirements

Nursing Home Discharge Notice Requirements

Federal Nursing Home Discharge Notice Requirments

Pursuant to 42 CFR § 483.15(b)(4) Admission, transfer, and discharge rights.

(4) Timing of the notice. (i) Except as specified in paragraphs (b)(4)(ii) and (b)(8) of this section, the notice of transfer or discharge required under this section must be made by the facility at least 30 days before the resident is transferred or discharged.

(ii) Notice must be made as soon as practicable before transfer or discharge when—

(A) The safety of individuals in the facility would be endangered under paragraph (b)(1)(ii)(C) of this section;
(B) The health of individuals in the facility would be endangered, under paragraph (b)(1)(ii)(D) of this section;
(C) The resident’s health improves sufficiently to allow a more immediate transfer or discharge, under paragraph (b)(1)(ii)(B) of this section;
(D) An immediate transfer or discharge is required by the resident’s urgent medical needs, under paragraph (b)(1)(ii)(A) of this section; or
(E) A resident has not resided in the facility for 30 days.

(5) Contents of the notice. The written notice specified in paragraph (b)(3) of this section must include the following:
(i) The reason for transfer or discharge;

(ii) The effective date of transfer or discharge;

(iii) The location to which the resident is transferred or discharged;

(iv) A statement of the resident’s appeal rights, including the name, address (mailing and email), and telephone number of the entity which receives such requests; and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request;

(v) The name, address (mailing and email) and telephone number of the Office of the State Long-Term Care Ombudsman;

(vi) For nursing facility residents with intellectual and developmental disabilities or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with developmental disabilities established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (Pub. L. 106-402, codified at 42 U.S.C. 15001 et seq.); and

(vii) For nursing facility residents with a mental disorder or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act.

(6) Changes to the notice. If the information in the notice changes prior to effecting the transfer or discharge, the facility must update the recipients of the notice as soon as practicable once the updated information becomes available.
(7) Orientation for transfer or discharge. A facility must provide and document sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility. This orientation must be provided in a form and manner that the resident can understand.
(8) Notice in advance of facility closure. In the case of facility closure, the individual who is the administrator of the facility must provide written notification prior to the impending closure to the State Survey Agency, the Office of the State Long-Term Care Ombudsman, residents of the facility, and the resident representatives, as well as the plan for the transfer and adequate relocation of the residents, as required at §483.70(l).
(9) Room changes in a composite distinct part. Room changes in a facility that is a composite distinct part (as defined in §483.5) are subject to the requirements of §483.10(e)(7) and must be limited to moves within the particular building in which the resident resides, unless the resident voluntarily agrees to move to another of the composite distinct part’s locations.

KLaBore@MNnursinghomeneglect.com
Please contact elder abuse and neglect Attorney Kenneth LaBore with any questions you may have at 612-743-9048.

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Documentation is Needed to Support Discharge From Nursing Home

Nursing Home Discharge Notice Documentation is Required

Nursing Home Discharge Notice Documentation is Required

Pursuant to federal regulation contained in 42 CFR 483.15(b)(2) Documentation. When the facility transfers or discharges a resident under any of the circumstances specified in paragraphs (c)(1)(i)(A) through (F) of this section, the facility must ensure that the transfer or discharge is documented in the resident’s medical record and appropriate information is communicated to the receiving health care institution or provider.

(i) Documentation in the resident’s medical record must include:

(A) The basis for the transfer per paragraph (c)(1)(i) of this section.
(B) In the case of paragraph (c)(1)(i)(A) of this section, the specific resident need(s) that cannot be met, facility attempts to meet the resident needs, and the service available at the receiving facility to meet the need(s).

(ii) The documentation required by paragraph (c)(2)(i) of this section must be made by—

(A) The resident’s physician when transfer or discharge is necessary under paragraph (c)(1)(A) or (B) of this section; and
(B) A physician when transfer or discharge is necessary under paragraph (b)(1)(i)(C) or (D) of this section.

(iii) Information provided to the receiving provider must include a minimum of the following:

(A) Contact information of the practitioner responsible for the care of the resident
(B) Resident representative information including contact information.
(C) Advance Directive information.
(D) All special instructions or precautions for ongoing care, as appropriate.
(E) Comprehensive care plan goals,
(F) All other necessary information, including a copy of the residents discharge summary, consistent with §483.21(c)

(2), as applicable, and any other documentation, as applicable, to ensure a safe and effective transition of care.

KLaBore@MNnursinghomeneglect.com
Please contact elder abuse and neglect Attorney Kenneth LaBore with any questions you may have at 612-743-9048

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Discharge Rights Designed To Protect Nursing Home Residents

Nursing Home Discharge Rights

Nursing Home Discharge Rights

Nursing Home Resident Discharge Rights

According to federal regulation 42 CFR § 483.15(c)  Admission, transfer, and discharge rights.

(c) (1) Facility requirements—(i) The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless—

(A) The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility;
(B) The transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility;
(C) The safety of individuals in the facility is endangered due to the clinical or behavioral status of the resident;
(D) The health of individuals in the facility would otherwise be endangered;
(E) 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. Non-payment applies if the resident does not submit the necessary paperwork for third party payment or after the third party, including Medicare or Medicaid, denies the claim and the resident refuses to pay for his or her stay. For a resident who becomes eligible for Medicaid after admission to a facility, the facility may charge a resident only allowable charges under Medicaid; or
(F) The facility ceases to operate.

Additional Right to Know About Nursing Home Discharge or Eviction

(ii) The facility may not transfer or discharge the resident while the appeal is pending, pursuant to §431.230 of this chapter, when a resident exercises his or her right to appeal a transfer or discharge notice from the facility pursuant to §431.220(a)(3) of this chapter, unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility. The facility must document the danger that failure to transfer or discharge would pose.

KLaBore@MNnursinghomeneglect.com
Please contact elder abuse and neglect Attorney Kenneth LaBore with any questions you may have at 612-743-9048.

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Minnesota Nursing Home Lawyer

MINNESOTA ELDER ABUSE AND NEGLECT LAWYER - MN Nursing Home Law


Kenneth L. LaBore, Esq, Phone: 612-743-9048 or Toll Free: 1-888-452-6589


This web site is designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. Minnesota Nursing Home Lawyer & Attorney of Kenneth LaBore - Attorney at Law, offering services related to elder abuse and neglect, nursing home, assisting living, and other senior or elder care facilities, serving Minneapolis, St Paul, Twin Cities, Bemidji, Rochester, Alexandria, Marshall, Grand Rapids, Anoka, Apple Valley, Arden Hills, Burnsville, Lakeville, St Cloud, Monticello, Duluth, Owatonna, Austin, Bloomington, Mankato and throughout Minnesota.


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