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Dumping on Hospitals

by Ira M. Leff, Esq.

January 4, 2010

Last week I wrote about the FAIR HOUSING ACT, which, among other things, criminalizes discrimination against handicap persons in the rental of property. I suggested that the Act can be used to persuade long-term care facilities not to reject or dump difficult residents. I received the following response from a hospital social worker:

We have nursing homes and assisted living facilities refuse to accept our patients back because they were agitated or combative at their facility before they transferred them to us. They always tell us that if a patient is a danger to himself or other residents that they can discharge him.

It is true, that with regard to nursing homes, where the resident or other residents are subject to an imminent and substantial danger that only immediate transfer or discharge will relieve or reduce, a facility may involuntarily transfer a resident without notice. O.C.G.A. § 31-8-116(a). In all other cases, (even if a physician determines that failure to transfer the resident will threaten the health or safety of the resident or others), the facility must assist the resident in finding a reasonable alternative placement and must give the resident at least 30 days notice before the transfer becomes effective.

In the case of personal care homes, the administrator or manager may initiate immediate transfer only if the resident develops a physical or mental condition requiring continuous medical care or nursing care or if the resident's continuing behavior or condition directly and substantially threatens the heath, safety and welfare of the resident or any other resident. DHR Regs. § 290-5-35-.23. In all other cases, the resident is entitled to 30 day's notice before a discharge. DHR Regs. § 290-5-35-.24.

It is my impression that nursing homes and personal care homes involuntarily discharge to hospitals some of their difficult residents when those residents do not meet the criteria for an immediate discharge. In those cases, the facilities should be obligated to accept the residents back who have been stabilized since they were not properly discharged. Hospitals need to be aware of the involuntary discharge standards as well as the FAIR HOUSING ACT to protect themselves from illegal dumping.

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