Section 4.09 - Discharge and TransfersIt shall be an unfair or deceptive act or practice, in violation of M.G.L. c. 93A, § 2, for a licensee or administrator
(1) to fail, in discharging or transferring a resident of a nursing facility, to comply with the Division of Medical Assistance regulations at 130 CMR 610.000et seq., or any substitute or further amended regulations promulgated by any successor state agency. Under 940 CMR 4.00, the obligation of a licensee or administrator includes but is not limited to providing a resident with advance written notice of the discharge or transfer, which notice shall include a statement informing the resident of his or her right to request a hearing before the Division of Medical Assistance. A licensee or administrator may discharge or transfer a resident only for one or more of the reasons set forth in 130 CMR 610.220(A).(2) to discharge or transfer a resident, when a state or federal agency refuses, or ceases to authorize payment for a Medicare or Medicaid resident until all administrative appeals have been exhausted;(3) to discharge or transfer a resident without documentation of the reason for such discharge or transfer in the clinical record by the resident's attending physician, unless the health or safety of individuals in the nursing facility would be endangered, in which case the reason for such discharge or transfer may be documented by a physician.(4) to move a resident to different living quarters within the facility, contrary to the resident's wishes, except to meet the resident's health care or safety needs which otherwise could not be met, as documented in the resident's clinical record by his/her attending physician;(5) to fail or refuse to readmit to the facility's next available bed in a semi-private room, a resident receiving or eligible to receive public assistance who had been transferred for hospitalization or therapeutic leave and whose absence exceeded the authorized bed-hold leave if that resident requires the facility's services; to fail or refuse to readmit to the facility's next available bed in a semi-private room, a resident who had been transferred for hospitalization or therapeutic leave if that resident requires the facility's services;(6) to fail to discuss the planned discharge or transfer from the facility with the resident and his/her legal representative or next of kin.(7) to fail to consult the resident and his/her family or legal representative in choosing another facility, and to take all reasonable steps to implement the resident's choice of such facility;(8) in an institution licensed by the Department of Public Health to provide chronic disease or rehabilitative services to a resident as defined by 940 CMR 4.01(12)(a) to fail or refuse to provide, except in the case of an emergency discharge or transfer, seven days advance written notice to the resident of a discharge or transfer; such written notice shall include:1. the date of the discharge or transfer;2. the location to which the resident is to be discharged or transferred;3. the reason for the discharge or transfer;4. a statement informing the resident of his/her right to request a hearing before the Division of Medical Assistance;5. the name, address and phone number of the local legal services office;(b) to fail or refuse to document for each resident who is to be discharged, a written discharge plan that specifies the services or care to be required by the resident, the frequency, intensity, and duration of such services, and the resources available to provide the care or services, including available family and community support; such a plan must be updated if the resident's condition changes significantly;(9) in a facility licensed by the Department of Public Health as a residential care facility, convalescent or rest home, infirmary maintained in a town, or charitable home for the aged - to fail or refuse to provide, except in the case of an emergency discharge or transfer, 30 days advance written notice to the resident of an anticipated discharge or transfer, such written notice shall include:(a) sufficient explanation for the discharge or transfer, including the facility's plans and procedures for discharge or transfer;(b) a statement that the resident has the right to express objection to his/her discharge or transfer to a representative of the facility;(c) the specific address of the location to which the resident is to be discharged or transferred;(d) a statement that all reasonable efforts have been taken by representatives of the facility to provide counseling to the resident to prepare him/her to adjust to any discharge or transfer;(e) the name, address and phone number of the local legal services office;(f) a statement that all reasonable precautions have been taken to eliminate or reduce any harmful effects that may result from the discharge or transfer.