SECTION 310:675-7-4. Resident transfers or discharge

(a)   Reasons for transfer or discharge. Involuntary transfer or discharge of a resident may be initiated by a facility only for one or more of the following:

(1)   Medical reasons, including needs that the facility is unable to meet, as documented by the attending physician, in consultation with the medical director if the medical director and attending physician are not the same person.

(2)   The resident's safety, or for the safety of other residents, as documented by the clinical record. The facility shall show through medical records that:

(A)   the resident has had a comprehensive assessment by an interdisciplinary team and alternative measures have been attempted unsuccessfully; or

(B)   the resident is a danger to himself, herself or other resident as documented by the medical record and the facility is not capable of managing that resident.

(3)   The non-payment of charges for the resident's care as documented by the facility's business records for services for more than 30 days.

(b)   Procedures. Procedures for involuntary transfer or discharge by the facility are as follows:

(1)   Written notice shall be provided at least thirty (30) days in advance of the transfer or discharge date to the resident, resident's legal representative, person responsible for payment of charges for the resident's care, if different from any of the foregoing, and the Department.

(2)   The ten day requirement shall not apply when an emergency transfer is mandated by the resident's health care needs and is in accordance with the attending physician's written orders and medical justification; or the transfer or discharge is necessary for the physical safety of other residents as documented in the clinical record. The facility shall not use a discharge to a hospital as a reason for failing to re-admit a resident after release from the hospital to the first available bed in a semi-private room. Such action shall be considered to be an involuntary discharge subject to all the requirements of this section, unless the discharge was required by the Department.

(3)   The written notice shall include:

(A)   A full explanation of the reasons for the transfer or discharge;

(B)   The date of the notice;

(C)   The date notice was given to the resident and the resident's representative;

(D)   The date by which the resident must leave the facility; and

(E)   Information that the resident's representative or person responsible for payment of the resident's care who is aggrieved by the facility's decision, may file within ten (10) days of notice a written request for a hearing with the Department by sending a letter to the Hearing Clerk, Oklahoma State Department of Health, 1000 NE Tenth Street, Oklahoma City, OK 73117.

(4)   Failure of the facility to give the notice as substantially specified above shall result in an order without hearing from the Department denying the right of the facility to discharge the resident.

(5)   If a written request for a hearing is properly filed by an eligible aggrieved party, the Department shall convene a hearing within ten working days of receipt of the request. The request may be in the form of a letter or a formal request for hearing from the resident or resident's representative. In the event that the resident is unable to write, a verbal request made to the hearing clerk shall be sufficient. The Department shall reduce the verbal request to writing and send a copy to the resident. The request should state the reason for the discharge and attach a copy of the letter from the facility.

(6)   During the pendency of the hearing, the facility shall not discharge the resident unless the discharge was required by the Department or is an emergency situation. If the resident relocates from the facility but wants to be readmitted, the Department may proceed with the hearing and the facility shall be required to readmit the resident to the first available bed in a semi-private room if the discharge is found not to meet the requirements of the Nursing Home Care Act and OAC 310:675.

(7)   The Department shall provide the Administrative Law Judge and the space for the hearing. The parties, including the resident and the facility, may be represented by counsel or may represent themselves.

(8)   The hearing shall be conducted at the Oklahoma State Department of Health building unless there is a request for the hearing to be held at the facility or at another place. Providing the hearing room in such a case shall be the responsibility of the parties. The Department shall maintain a record on the case as it does for any other individual proceeding.

(9)   The hearing shall be conducted in accordance with the Department's procedures, Chapter 2 of this Title. The Administrative Law Judge's order shall include findings of fact, conclusions of law and an order as to whether or not the transfer or discharge was according to law. If a facility receives federal funds for services, it shall also comply with the certification standards. The more restrictive rule toward the facility shall be applied.

(10)   If the Administrative Law Judge finds that the discharge was not according to law, the Department shall review, investigate and issue deficiencies as appropriate.

(11)   If the discharge is according to law, the order shall give the facility the right to discharge the resident.

(12)   The scope of the hearing may include:

(A)   Inadequate notice;

(B)   Discharge based on reason not stated in the law;

(C)   Sufficiency of the evidence to support the involuntary discharge; or

(D)   The finding of emergency.

(13)   The Administrative Law Judge shall render a written decision within ten working days of the close of the record.

(14)   If the Administrative Law Judge sustains the facility, the facility may proceed with the discharge. If the Administrative Law Judge finds in favor of the resident, the facility shall withdraw its notice of intent to transfer or discharge the resident. The decision of the Administrative Law Judge shall be final and binding on all parties unless appealed under the Administrative Procedures Act.

(c)   Room relocation

(1)   If a facility wants to relocate a resident from one room toanother, the facility shall give the resident at least forty-eight hours written notice. The notice shall include the cost of transferring the resident's telephone, if applicable.

(2)   If the resident or the resident's representative agrees in writing to the relocation, the relocation may take place in less than forty-eight hours.

(3)   No hearing is required if the resident requests or agrees to relocation from one room to another.

[Source: Amended at 9 Ok Reg 3163, eff 7-1-92 (emergency); Amended at 10 Ok Reg 1639, eff 6-1-93; Amended at 20 Ok Reg 2399, eff 7-11-03; Amended at 26 Ok Reg 2059, eff 6-25-09]