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Overview
Connecticut state law and federal law prohibit forced room-to-room
transfers (also referred to as "intra-facility transfers") with very few
exceptions. The law recognizes that involuntary transfers may be disruptive or harmful for
residents and generally permit a resident to stay put. The law always requires nursing
homes to provide advance written notice of any proposed transfer and allows residents to
sue nursing homes for violations of the law. Below is an explanation of the law on
room-to-room transfers
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When are
room-to-room transfers permitted?
In most situations, room-to-room transfers are unlawful.
The need for particular types of medical care should never be the
basis for a transfer since nurses, doctors and therapists can always go the resident.
Staffing levels should never be a factor. Federal law requires that appropriate,
individualized care be provided to every resident of every nursing home, regardless of
where the resident is located within a facility. Nursing homes are always required to
adjust the staffing levels of nurses, therapists and aides as needed to provide optimum
care for residents throughout the home.
A nursing home can not permanently transfer residents to make
changes in the facility such as the creation of specialized care units or the closing of
certain wings, are prohibited.
Even when the law allows a transfer, a nursing home may never move
a resident within the nursing home unless a doctor conducts a comprehensive evaluation and
determines that the transfer would not cause transfer trauma. A transfer is only allowed
if the doctor documents in the medical records that a transfer will not "cause new
symptoms or exacerbate present symptoms beyond a reasonable adjustment period resulting in
a prolonged or significant negative outcome that could not be ameliorated through care
plan intervention."
Under federal law, residents have an absolute right to refuse to
accept (1) a transfer from the portion of a nursing home designated as the Medicare wing
or Medicare "distinct part" to any other portion of the home of (2) a transfer
from the portion of a nursing home designated as the Medicaid wing or Medicaid
"distinct part" to any other portion of the home.
Room-to-room transfer are permitted only in following instances: If it is necessary to promote the patient's
well-being. This would include situations where a transfer is needed to isolate a
resident to prevent the spread of an infectious disease or necessary specialized equipment
is needed that can not be brought to the resident’s current room.
If roommates are so incompatible that a
resident is at risk.
If a temporary transfer is needed to make
repairs or renovations. Transfer is this situation are only allowed if the transfer
will promote the resident’s well-being. The resident has the right to return as soon
as the repairs or renovations are completed.
If the transfer is necessary to permit the
admission of a resident of the opposite sex. This is allowed on when (1) there are two
persons of the same sex living alone in double rooms, (2) there is no applicant of that
sex seeking admission and (3) the transfer of one of the two patients of the same
sex into one room would allow admission of patients of the opposite sex.
If (1) the patient no longer needs
specialized medical equipment that can not be move from the patient’s room, (2)
another patient needs access to that equipment and (3) the transfer would improve the
well-being of the resident being transferred.
If the patient no longer needs the
specialized services or programming that is the focus of the area of the facility in which
the patient is located and the transfer would improve the resident’s well-being.
If facility wants to transfer a Medicaid
recipient from a private room to a nonprivate room.
If a temporary transfer is necessary because
of an emergency. This includes transfer (1) to protect the resident or others from
physical harm, (2) to control the spread of an infectious disease, or (3) because of a
building or environmental emergency or other situation that threatens the resident’s
health or safety.
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Even when room-to-room transfer is legally permissible, the
nursing home must usually provide advance written notice to the resident and the
resident’s family. In most cases, the resident must be asked about transferring
and, if the resident does not consent to the transfer, there must be a meeting with the
resident, the resident’s family, the resident’s doctor and nursing home
staff. The consultation is to determine if the move is necessary and whether there
are alternatives to a transfer. The specific rules on notice and consultations vary
depending on the reason for the proposed transfer. In emergency situations, for
example, the resident can be moved before there is written notice or a consultative
process.
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The facility has the obligation to tell residents how to challenge
proposed transfers.
42 Code of Federal Regulations §
483.10 (b). Resident rights.
Connecticut General Statutes § 19a-550 (b) (5).
Patients' Bill of Rights.
Facilities that attempt to transfer residents in violation of the
law or without providing them with the required advance written notice can be sued. The
courts are authorized to issue injunctions to prevent transfers, to order facilities to
reverse transfer, and to make nursing homes pay compensatory and punitive damages.
Residents may also file complaints with the Connecticut Department of Public Health
against nursing homes and nursing home administrators that violate these rights.
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Room-to-room transfers are covered by the following state law and
federal regulations.
Connecticut General Statutes § 19a-550 (b) (23), (c), (d) and (e). Patients’ Bill of Rights.
42 United States Code §
1395i-3 (c) (1) (A) (x).
Requirements for, and assuring quality of care in, skilled nursing facilities. Requirements relating to residents' rights. Refusal of certain transfers.
42 United States Code §
1395i-3 (c) (1) (A)
(v). Requirements for, and assuring quality of care in, skilled nursing facilities.
Requirements relating to residents' rights. Accommodation of needs.
42 Code of Federal Regulations §
483.10 (o). Resident rights. Refusal of certain
transfers.
42 Code of Federal Regulations § 483.15 (e) (2).
Quality of life. Accommodation of needs.
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Additional information and assistance can be obtained from the Office of the Long-Term Care
Ombudsman or from Connecticut’s Legal Services organizations.
Visit the Nursing Home
Advocacy section of this web site.
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