Involuntary discharges could lead to a fine mess

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John O'Connor
John O'Connor

Operators might want to keep an eye on new involuntary discharge legislation under consideration in Illinois.

The measure, if approved, would let the state's health department readmit patients to a skilled care facility after an involuntary discharge. Buildings that refuse to take back residents could be fined up to $250 a day. House and Senate versions of the legislation are pending.

State Sen. Daniel Biss (D-9) said he finds it alarming that involuntary nursing home discharges have more than doubled in the past five years.

State Rep. Chris Welch (D-7) added that “Illinois leads the nation in the improper discharge of long-term care residents – in many instances, abandoning seniors with Alzheimer's and individuals with disabilities to hospital psychiatric units.”

Not surprisingly, provider groups oppose the legislation. “It has a lot of very punitive language in it and has incredible amounts of fines," Matt Hartman, with the Illinois Health Care Association, said at a recent hearing. He added that the legislation is far too excessive.

To be sure, there are very good reasons to evict a resident from a facility. In fact, the Centers for Medicare & Medicaid Services spelled out five of them in revised regulations released last November. According to the update, an involuntary transfer or discharge can take place if:

•  The facility cannot meet the resident's needs

•  The resident no longer requires such services

•  The resident poses a danger to others

•  The resident has failed to pay

•  The facility is closing

Biss said that he's hearing more complaints from constituents about facilities that transfer residents without prior warning. He added that many operators now seem interested in residents who are likely to generate the highest possible reimbursement.

Whether this legislation will pass remains an open question. After all, Illinois has not even been able to approve a state budget for two years.

Still, there are some troubling issues here. For one, it does seem to give the health department an awful lot of authority.

Then there's always the possibility that lawmakers in other states might decide to push for something similar.

Stay tuned.

Email John O'Connor at john.oconnor@mcknights.com.

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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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