Resident Discharge Planning

Without discharge planning and proper relocation procedures (especially with developmentally disabled, elderly, and emotionally disturbed residents), relocation stress syndrome may develop.  Transferring from one environment to another causes physiological and psychological impairment that is actually known to cause serious illness (and can even be fatal).  However, the good news is, a change in routine and this syndrome can be mitigated with proper transition.

A facility may not discharge involuntarily unless any of the following apply:

  • The resident may initiate transfer or discharge at any time (within the terms of the admission/service agreement) as long as they are not on a Chapter 51 or a Chapter 55.
  • If a resident is incompetent, as found via Chapter 54, protests his or her stay, the facility must notify the care team and county protective services agency to obtain determination regarding whether or not to discharge.

The facility is not to discharge voluntarily, unless any of the following apply:

  • A 30-day written advance notice is give to the resident and their respective care care team, as well as the reason for the discharge (and possible alternatives).
  • The home provides assistance in relocating the resident and ensures that the new home or living arrangement is suitable to meet the needs of the resident before actually discharging them.

Note: There are reasons acceptable for involuntary discharge:

  • Nonpayment of charges as long as there is a reasonable opportunity to pay.
  • Care is required beyond what the facility can provide.
  • The resident requires care above and beyond the home’s program statement and terms of the admission/service agreement.
  • The resident requires medical care that the home cannot provide.
  • There is an immediate risk of serious harm to the health, safety, or welfare to the resident, other residents, or staff as documented (in the resident’s record).

What should the administrator do to help ease the adjustment?

  • Promptly inform the resident, i.e. provide the 30-day notice.
  • Assess the needs and preferences of the resident. Do not coerce, bribe, or retaliate.
  • Provide a tour; provide options (written and verbally); explain the benefits… and even the cons.
  • Allow them to ask questions; listen to their concerns.
  • Involve their care team.
  • Be sure to help them pack their belongings and try to make their new area similar to their old area.
  • Be sure to have their needs met at the new placement.
  • Monitor signs for added stress regarding the move.
  • Keep in mind their rights!
  • Prepare appropriate documentation and maintain all necessary documentation.
  • Orient staff appropriately.

Just remember that the facility is the resident’s home and moving is a “big deal” for them.  Make the move as comfortable as possible and display empathy throughout the entire process.