Page:United States Statutes at Large Volume 101 Part 2.djvu/961

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-167

resident no longer needs the services provided by the facihty; "(iii) the safety of individuals in the facility is endangered; "(iv) the health of individuals in the facility would otherwise be endangered; "(v) the resident has failed, after reasonable and appropriate notice, to pay (or to have paid under this title or title XIX on the resident's behalf) an allowable charge imposed by the facility for an item or service requested by the resident and for which a charge may be imposed consistent with this title and title XIX; or "(vi) the facility ceases to operate. In each of the cases described in clauses (i) through (v), the basis for the transfer or discharge must be documented in the resident's clinical record. In the cases described in clauses (i) and (ii), the documentation must be made by the resident's physician, and in the cases described in clauses (iii) and (iv) the documentation must be made by a physician. "(B) PRE-TRANSFER AND PRE-DISCHARGE NOTICE.—

"(i) IN GENERAL.—Before effecting a transfer or discharge of a resident, a skilled nursing facility must— "(I) notify the resident (and, if known, a family member of the resident or legal representative) of the transfer or discharge and the reasons therefor, "(II) record the reasons in the resident's clinical record (including any documentation required under subparagraph (A)), and "(III) include in the notice the items described in clause (iii). "(ii) TIMING OF NOTICE.—The notice under clause (i)(I) must be made at least 30 days in advance of the resident's transfer or discharge except— "(I) in a case described in clause (iii) or (iv) of subparagraph (A); "(II) in a case described in clause (ii) of subparagraph (A), where the resident's health improves sufficiently to allow a more immediate transfer or discharge; "(III) in a case described in clause (i) of subparagraph (A), where a more immediate transfer or discharge is necessitated by the resident's urgent medical needs; or "(IV) in a case where a resident has not resided in the facility for 30 days. In the case of such exceptions, notice must be given as many days before the date of the transfer or discharge as is practicable. "(iii) ITEMS INCLUDED IN NOTICE.—Each notice under clause (i) must include— "(I) for transfers or discharges effected on or after October 1, 1990, notice of the resident's right to appeal the transfer or discharge under the State process established under subsection (e)(3); and "(II) the name, mailing address, and telephone number of the State long-term care ombudsman

91-194 O - 90 - 31: QL.3 Part 2

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