By Walter F. Roche Jr.
Some 300 Massachusetts nursing home patients were being rushed to new facilities without notice despite state and federal requirements that so-called involuntary transfers from nursing homes be limited to specific circumstances and that patients be given notice of their right to an appeal.
So far the mass transfers have been announced for two nursing homes, one in Worcester, the other in Wilmington. But state officials have made it clear they are intent on expanding the program to provide some 1,000 beds for patients recovering from Covid-19.
Massachusetts regulations regarding so called involuntary transfers and discharges state, ". A facility may not discharge or transfer a resident "unless the resident or appropriate representative consented in writing to the discharge or transfer."
Federal regulations set only six justifications including the patient no longer requires the level of care provided or the facility cannot provide the necessary level of care. In addition is the patient files an appeal the transfer must be put on hold.
The transfer of 147 patients at Beaumont at University Place in Worcester was first disclosed a week ago and by early this week Beaumont patients were being transferred to other nursing homes owned by Salmon Health Care, the owner of Beaumont.
The transfers were interrupted only when it was discovered that several of the current residents already were infected with Covid-19.
Beaumont patients and their representatives only learned of the imminent transfers a week ago in a facebook post by the Salmon's, chief executive officer, Matthew Salmon.
Interviews with relatives of the Beaumont patients show none were informed individually for the transfer nor were they given a medical justification, as required.
An additional 142 patients at the Advinia Care in Wilmington also have been targeted for transfer to other homes owned by the home's parent, Pointe Group Care. That move was also put on hold today after many patients also tested positive for covid-19 despite showing no symptoms.
Questions posed to both companies about compliance with the state and federal involuntary transfer requirements went unanswered.
Massachusetts officials, including aides to Baker, also did not respond to a series of questions about involuntary transfer rules.
The rushed transfers and the manner in which they were disclosed has prompted protests from the families of current and former patients at the two facilities.
Rev. Megan Leary, who had two grandparents at the facility for several years said the way the transfers were implemented was "unethical at best."
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A nursing home is allowed to involuntarily transfer or discharge your loved one only under the following six specific conditions.
The facility cannot meet the resident’s needs, therefore the move is necessary for his/her welfare.
The resident no longer needs nursing facility services due to improved health.
The resident’s presence endangers the safety of residents and others in the facility.
The resident’s presence endangers the health of residents and others in the facility.
After reasonable and appropriate notice, the resident has failed to pay for living in the facility.
The facility is closing.
nursing home typically must provide notice of transfer or discharge in writing at least 30 days before the proposed transfer/discharge. However, notice can be given “as soon as practicable” in the following situations:
The resident has lived in the facility for less than 30 days.
The resident’s improved condition allows for a more immediate transfer or discharge.
The resident’s urgent medical needs cannot be met in the facility (for example, an emergency transfer to the hospital).
The health or safety of others in the facility is endangered.
The transfer/discharge notice must be given to the resident, resident representative, and the Long-Term Care Ombudsman Program. The notice must include:
Reason for the transfer/discharge.
Proposed effective date.
Location to which the resident will be transferred or discharged.
Information on appeal rights.
Contact information for the Long-Term Care Ombudsman Program and (if applicable) agencies responsible for advocacy on behalf of persons with intellectual and developmental disabilities, or persons with mental disorders.
Documentation needs to be provided from a physician if the transfer/discharge is related to either the resident’s health, or the health/safety of other residents.
To help prevent a nursing home’s inclination to transfer residents perceived as being difficult or “heavy care”, but whose care needs fall within the level of services required by Federal law, the resident’s physician must document:
Specific need(s) that the facility allegedly cannot meet.
Attempts by the facility to meet the need(s).
Services available at the receiving facility that supposedly will meet the need(s).
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