Residents of long-term care facilities have the right to refuse room transfers

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kathy heren

By Kathy Heren

I feel it’s important to write on subjects that can directly impact the well-being of residents of long-term care facilities. Recently, we have received complaints from families concerning room changes or inertia-facility transfers.  Residents are protected from that practice by The Resident’s Bill of Rights, which is a federal law.

Residents cannot be told they are having a room change for the convenience of the facility. Administrators can ask residents if they would be willing to change their room, but if a resident refuses, then it’s no. Under federal law, residents have the absolute right to refuse to accept:

• A transfer from the portion of a nursing home designated as the Medicare wing. The only exception is if the resident or a member of his or her family signs an admission agreement that clearly states that after the patient completes skilled Medicare rehabilitation services, the facility cannot guarantee a long-term care bed for permanent placement. I don’t like it when facilities only want Medicare residents and try to avoid accepting residents who may become Medicaid eligible if they remain at the facility.

• A transfer from the portion of the nursing home designated as the Medicaid wing to another portion of the home. Room-to-room transfers could be permitted if the transfer is necessary to promote the well-being of residents. It could be necessary to isolate a resident to prevent the spread of a communicable disease; or it could be necessary to conduct a transfer because roommates are so incompatible that they are both at risk of being injured.

Even if a room change is reasonable, the facility must provide advanced written notice to the resident and his or her family. If there is a refusal, a meeting should occur, and it should include the staff of the facility, the family, the resident and his or her physician. The meeting can determine if the move is really necessary, and if there are there any alternatives to the move. In the case of an emergency, it is common sense to make a transfer to protect residents.

Families can notify the Center for Health Facility Regulations under the Rhode Island Department of Health, my office or both if the administration of a facility ignores the objection to a transfer from the impacted resident or his or her family member.

It is also unacceptable to make transfers because staffing levels are better on another unit. The administrators of long-term care facilities must adjust their staffing levels even if a special care unit is established or a wing of a facility is closed.

You have heard of “eminent domain” in the public arena, but that rule does not apply in the long-term care sector. Imagine if a municipal official notified you in person or by letter that you have to move because the city or town wants your property for a parking lot. What would that do to you? A resident’s room is the person’s home, and the individual would feel the same way.

Do not let people push you around when it comes to room changes. You can find out if the move is acceptable or if you need an advocate. Please call our office and let us be sure a resident’s rights are not being violated. Most administrators of long-term care facilities know the law and act appropriately. There are, however, a few that will try to ignore residents’ rights for the benefit of the facility.

Kathleen Heren is executive director of the Rhode Island Long-Term Care State Ombudsman Office. Contact her at (401) 785-3340 or (888) 351-0808.

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