HARRY HUGHES, Governor

2989

RESIDENT WHO IS, OR WILL BECOME, A MEDICAL ASSISTANCE
RECIPIENT, IS PRESUMED TO BE PROPOSING THE DISCHARGE OR
TRANSFER FOR AN UNALLOWABLE CAUSE. If [such] AN ALLOWABLE
cause is reasonably believed to exist, THE FACILITY SHALL
GIVE the patient or resident and the guardian or next of kin
of the patient or resident shall be given at least [thirty
(30)] 30 days advance WRITTEN notice of the proposed action

together with the reasons for the decision and an

opportunity for an impartial hearing to challenge such
action if the patient so wishes. In emergencies such notice
need not be given IN ADVANCE.

(18) (I) A PATIENT OR RESIDENT MAY NOT BE
TRANSFERRED OR DISCHARGED INVOLUNTARILY FROM A SKILLED
NURSING FACILITY OR INTERMEDIATE CARE FACILITY EXCEPT FOR:

1.  MEDICAL REASONS;

2.  THE PATIENT'S OWN OR OTHER
PATIENT'S WELFARE;

3.  VIOLATION OF CONTRACT PROVISIONS
BY KNOWINGLY DIVESTING HIMSELF OF HIS PERSONAL ASSETS FOR
THE SOLE PURPOSE OF RECEIVING MEDICAL ASSISTANCE; OR

4.  NONPAYMENT FOR THE STAY.

(II)  PAYMENT AS A MEDICAL ASSISTANCE
RECIPIENT MAY NOT CONSTITUTE NONPAYMENT TO A MEDICAID
CERTIFIED FACILITY FOR PURPOSES OF THIS PARAGRAPH.

(III)  A MEDICAID CERTIFIED FACILITY
PROPOSING TO DISCHARGE OR TRANSFER UNDER THIS PARAGRAPH A
PATIENT OR RESIDENT WHO IS, OR WILL BECOME, A MEDICAL
ASSISTANCE RECIPIENT IS PRESUMED TO BE PROPOSING THE
DISCHARGE OR TRANSFER FOR AN UNALLOWABLE CAUSE.

(IV)  IF AN ALLOWABLE CAUSE UNDER THIS
PARAGRAPH IS BELIEVED REASONABLY TO EXIST, THE FACILITY
SHALL GIVE THE PATIENT OR RESIDENT AND THE GUARDIAN OR NEXT
OF KIN OF THE PATIENT OR RESIDENT AT LEAST 30 DAYS ADVANCE
WRITTEN NOTICE OF THE PROPOSED ACTION TOGETHER WITH THE
REASONS FOR THE DECISION AND AN OPPORTUNITY FOR AN IMPARTIAL
HEARING TO CHALLENGE THE ACTION IF THE PATIENT SO WISHES.
IN EMERGENCIES THE NOTICE NEED NOT BE GIVEN IN ADVANCE.

(V)  AN ADMISSION CONTRACT OF A MEDICAID
CERTIFIED FACILITY MAY NOT REQUIRE A PATIENT TO REMAIN A
PRIVATE PAY PATIENT FOR MORE THAN 12 MONTHS AS A CONDITION
FOR REMAINING IN THE NURSING HOME IN THE EVENT THE PATIENT
BECOMES MEDICAID ELIGIBLE.

SECTION 2. AND BE IT FURTHER ENACTED, That the
Department of Health and Mental Hygiene shall conduct a
study concerning appropriate methodologies for the
reimbursement of nursing homes under the Medical Assistance