AHCA/NCAL: Focus F-Tag of the Week

The Centers for Medicare and Medicaid Services (CMS) made changes to the §483.15-Admission, Transfer, and Discharge guidance. Changes include the following citations:

• F622-Transfer and Discharge Requirements. CMS provided clarification language for situations involving discharge from short-term rehabilitation, when Medicare coverage ends but the resident still needs long-term care, assisting residents to apply for Medicaid and explanation for denials, emergent transfers to acute care, and permitting return to nursing home.

• F623-Notice Requirements Before Transfer/Discharge. CMS provided clarification on the components the transfer or discharge notice should contain and that a new notice would be required if a change in destination occurs.

• F626-Permitting Residents to Return to Facility. CMS provided clarification that the requirement to permit residents to return after hospitalization or therapeutic leave applies to all residents regardless of payment source. CMS added language to investigative procedure to help surveyors investigate situations where a facility does not permit a resident return as well as added a deficiency categorization example to show harm from a facility not permitting a resident to return after a hospitalization.

For all three citations, CMS added language that addresses against medical advice discharges.

Detailed information can be found in the Appendix PP-State Operations Manual. AHCA has also provided a §483.15(c)(1) Planning Tool.

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Please email regulatory@ahca.org for additional questions or visit the Survey Preparedness page for more information.

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NYSHFA/NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Tarrah Quinlan, RN, BSN
Director of Education Program Development and Member Operations
518-462-4800 x20