Nursing facility notified appellant that it intended to discharge her because she was a danger to others; facility did not meet the regulatory requirements related to discharge; notice from facility does not indicate that it was mailed to a designated family member; representative from agency did not clearly indicate how discharge location would be safe or appropriate for appellant.
- Issue is whether MassHealth was correct in determining the number of CSN hours and PCA hours that are medically necessary for the appellant. MassHealth ordered to remove aid pending and rescind notice. Then send notice of the authorized hours that appellant can receive.
Hearing officer agreed facility had sufficient grounds to discharge; appellant smoked without supervision in facility including in her room; danger to other residents; discharge notice met regulatory requirements; however, there was a lack of the required documentation by a physician.
Nursing facility did not meet its burden to support its discharge notice; nursing facility did not appear at hearing; nursing facility did not show good cause regarding failure to appear.
Appellants have failed, after reasonable and appropriate notice, to pay for or have a third party pay for their stay at the facility and thus may be discharged; however, the facility has not provided sufficient preparation and orientation to Appellants to ensure safe and orderly transfer or discharge from the facility to another safe and appropriate place.
Appellant must have “sufficient preparation and orientation to ensure a safe and orderly transfer to another safe and appropriate place”; the record strongly suggests that the appellant’s previous place of residence, shared with her son, is not a “safe and appropriate place.”
No adequate and acceptable documentation in the clinical record, from the resident’s physician, signing off on and attesting to the statement that this Appellant’s health has improved sufficiently enough to make the discharge appropriate; nursing facility has already failed twice in trying to serve Appellant with proper and appropriate notices; while the nursing facility is free to make another attempt, the nursing facility is strongly encouraged to review the applicable law and regulations quoted within this decision, and make sure that its notice, discharge planning, and paperwork prepared for hearing comply with all the regulatory law and the requirements given by the Board of Hearings.
Nursing facility’s notice simply does not comply with many requirements of Massachusetts law; nowhere in the notice is the specific name of the contact person at the facility given; the address of an appropriate legal services offices be given with such notice; nursing facility required to say how much time the Appellant has to request an appeal.
Nursing facility has valid grounds to discharge the appellant per its notice dated April 2, 2012; met its burden of providing sufficient preparation and orientation to the resident to ensure safe and orderly discharge; nursing facility actively involved the appellant in selecting the discharge location when the representatives met with the appellant and discussed possible discharge locations.