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The Centers for Medicare & Medicaid Services (CMS) has issued the attached Survey & Certification Letter 18-08 describing an initiative to address facility-initiated discharges from skilled-nursing facilities that violate federal regulations. CMS notes that while federal law protects skilled-nursing facility residents, including their right to remain in the facility except under certain specific circumstances, state long-term care ombudsmen report frequent complaints of facility-initiated discharge or eviction.
CMS notes that the most commonly reported reasons for facility-initiated discharge or eviction are behavioral, mental or emotional expressions or indications of resident distress. In some cases, residents become homeless or remain in hospitals for extended periods.
To address this issue, CMS will now require state survey agencies to refer cases involving facility-initiated discharge violations to the CMS regional office when the resident was placed in a questionable or unsafe setting or remains hospitalized, as well as other circumstances. The regional office will review and may take enforcement action as indicated. CMS is also considering surveyor and provider training and encourages states to use civil monetary penalty funds for projects that would improve performance.
