Nursing Home Refusals and Transfer to Hospice or Hospitals: Navigating Legal Landscapes

In the context of end-of-life care, nursing homes and hospice facilities play distinct roles. Nursing homes are primarily designed for basic care and supervision, whereas hospice facilities specialize in managing the needs of terminally ill patients with extensive medical care and pain management.

Understanding the Differences and Laws

Nursing homes, while crucial for many elderly residents, are not necessarily set up to handle the extensive medical needs of those nearing the end of life. Due to the specific nature of end-of-life care, including pain management and specialized nursing services, hospice facilities are the more appropriate setting. However, the laws vary by location and are generally designed to facilitate easy access to end-of-life care for those who need it. Some key points to consider include:

The staffing levels of nursing homes, defined by the number of hours a registered nurse (RN) or licensed practical nurse (LPN) can provide to unregistered nursing aides per 24 hours.

The presence of palliative care rooms within nursing homes, where terminally ill residents can be moved for specialized care.

The limitations of nursing homes in admitting residents who require more intensive care or specific medical interventions.

The potential need for a memory care facility with lock-down areas for agitated dementia patients.

Legal and Policy Considerations

While there may not be specific laws mandating nursing homes to accept terminally ill residents who need to be transferred to hospice, these facilities often have policies reflecting the limitations of their resources and staff. If a nursing home refuses to accept a terminally ill resident, it can be due to the following reasons:

Limited staffing: Nursing homes may not have the necessary medical personnel to provide the required level of care, especially for patients with complex needs.

Regulatory compliance: Nursing homes must adhere to strict federal regulations set by the Department of Health and Human Services. If they cannot meet the specific needs of the patient, they may be required to transfer the patient to another facility.

Prognosis: Starting hospice means the patient's prognosis is within six months. This period may not align with the immediate care needs of the patient.

Importantly, if a nursing home refuses to accept a terminally ill resident, the resident and their family may have legal rights to seek alternative care. These legal rights can be found in state and federal guidelines, which mandate the provision of appropriate care. It is crucial to document the situation and follow the appropriate legal channels.

Seeking Assistance

If you are facing difficulties in obtaining the necessary care for a terminally ill loved one, contacting relevant organizations and government agencies can provide assistance. Here are a few steps to consider:

Contact the Department of Health and Human Services to inquire about the conditions under which a nursing home can evict a patient. Explaining the situation to them can help determine the next steps.

Reach out to your state's department on Elder Abuse to explore if the current facility is not suitable and if a transfer to another facility is necessary.

Engage with hospice care services to determine if they can provide ongoing support and if there is a shortage of facilities providing inpatient hospice care.

Consider the local hospital as an alternative, especially if the patient needs immediate medical intervention or if the hospice care can provide long-term support.

Navigating these challenges can be complex and overwhelming. It is essential to seek help from professionals and advocate for the care that your loved one needs. By understanding the legal and policy frameworks, you can better navigate the challenges and ensure your loved one receives the appropriate end-of-life care.

Keywords: end-of-life care, nursing home policies, hospice transfer laws