HB 6317 — AN ACT PROHIBITING DISCHARGES FROM NURSING HOMES AND RESIDENTIAL CARE HOMES TO TEMPORARY OR UNSTABLE HOUSING.

House of Representatives General Assembly FileSubstitute Bill No.

2596317 January Session, 2021 SubstituteAN HouseACT BillPROHIBITING No.DISCHARGES FROM NURSING HOMES AND RESIDENTIAL CARE HOMES TO TEMPORARY OR UNSTABLE HOUSING.

6317 House of Representatives, April 6, 2021 The Committee on Human Services reported through REP.

ABERCROMBIE of the 83rd Dist., Chairperson of the Committee on the part of the House, that the substitute bill ought to pass.

AN ACT PROHIBITING DISCHARGES FROM NURSING HOMES AND RESIDENTIAL CARE HOMES TO TEMPORARY OR UNSTABLE HOUSING.

(3) "transfer" means the movement of a resident from one facility to another facility or institution, including, but not limited to, a hospital emergency sHB6317department, /if Filethe No.resident is admitted to the facility or institution or is under the care of the facility or institution for more than twenty-four hours;

259(4) 1"discharge" sHB6317means Filethe movement of a resident from a facility toanoninstitutionalsetting;(5)"self-payresident"meansaresidentwho is not receiving state or municipal assistance to pay for the cost of care LCO \\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06317-R01 of 10 HB.docx Substitute Bill No.

2596317 department,at ifa thefacility, but shall not include a resident iswho admittedhas tofiled thean facilityapplication orwiththeDepartmentofSocialServicesforMedicaidcoverageforfacility institutioncare orbut ishas undernot received an eligibility determination from the caredepartment ofon such application, provided the facilityresident orhas institutiontimely responded to requests by the department for moreinformation thanthat twenty-fouris hours;necessary to make such determination;

(4) "discharge" means the movement of a resident from a facility toanoninstitutionalsetting;(5)"self-payresident"meansaresidentwho is not receiving state or municipal assistance to pay for the cost of care at a facility, but shall not include a resident who has filed an application withtheDepartmentofSocialServicesforMedicaidcoverageforfacility care but has not received an eligibility determination from the department on such application, provided the resident has timely responded to requests by the department for information that is necessary to make such determination;

A facility that is part of a continuing care facility which guarantees life care for its residents may transfer or discharge (1) a self-pay resident who is a member of the continuing care community and who has intentionally transferred assets in a sum that will render the resident unable to pay the costs of facility care in accordance with the contract between the resident and the facility, or (2) a self-pay resident who is not a member ofthecontinuing care community andwho hasintentionally transferred assets in a sum that will render the resident unable to pay the costs of a sHB6317total /of Fileforty-two No.months of facility care from the date of initial admission to the facility.

259(c) 2(1) sHB6317Before Fileeffecting any transfer or discharge of a resident from the LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06312 of 10 R02-HB.docx } Substitute Bill No.

2596317 totalfacility, thefacility shallnotify,inwriting,theresident andtheresident's guardian or conservator, if any, or legally liable relative or other responsible party if known, of forty-twothe monthsproposed transfer or discharge, the reasonstherefor,theeffective dateoftheproposedtransferordischarge, the location to which the resident is to be transferred or discharged, the right to appeal the proposed transfer or discharge and the procedures for initiating such an appeal as determined by the Department of facilitySocial careServices, fromthe date by which an appeal must be initiated in order to preserve the resident's right to an appeal hearing and the date by which an appeal must be initiated in order to stay the proposed transfer or discharge and the possibility of initialan admissionexception to the facility.date by which an appeal must be initiated in order to stay the proposed transfer or discharge for good cause, that the resident may represent himself or herself or be represented by legal counsel, a relative, a friend or other spokesperson, and information as to bed hold and nursing home readmission policy when required in accordance with section 19a-537.

(c) (1) Before effecting any transfer or discharge of a resident from the facility, thefacility shallnotify,inwriting,theresident andtheresident's guardian or conservator, if any, or legally liable relative or other responsible party if known, of the proposed transfer or discharge, the reasonstherefor,theeffective dateoftheproposedtransferordischarge, the location to which the resident is to be transferred or discharged, the right to appeal the proposed transfer or discharge and the procedures for initiating such an appeal as determined by the Department of Social Services, the date by which an appeal must be initiated in order to preserve the resident's right to an appeal hearing and the date by which an appeal must be initiated in order to stay the proposed transfer or discharge and the possibility of an exception to the date by which an appeal must be initiated in order to stay the proposed transfer or discharge for good cause, that the resident may represent himself or herself or be represented by legal counsel, a relative, a friend or other spokesperson, and information as to bed hold and nursing home readmission policy when required in accordance with section 19a-537.

sHB6317(2) /The Fileresident may initiate an appeal pursuant to this section by submitting a written request to the Commissioner of Social Services not later than sixty calendar days after the facility issues the notice of the LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-063173 of 10 R02-HB.docx } Substitute Bill No.

2596317 3proposed sHB6317transfer Fileor No.discharge, except as provided in subsection [(h)] (i) of this section.

259 (2) The resident may initiate an appeal pursuant to this section by submitting a written request to the Commissioner of Social Services not later than sixty calendar days after the facility issues the notice of the proposed transfer or discharge, except as provided in subsection [(h)] (i) of this section.

In addition, the plan shall outline the care and kinds of services that the sHB6317resident /shall Filereceive No.upon transfer or discharge.

259Not 4less sHB6317than Filethirty days prior to an involuntary transfer or discharge, a copy of the LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06317-4 of 10 R02-HB.docx } Substitute Bill No.

2596317 residentdischarge plan shall receivebe uponprovided transferto the resident's personal physician or discharge.advanced practice registered nurse if the discharge plan was prepared by the medical director, to the resident and the resident's guardian or conservator, if any, or legally liable relative or other responsible party, if known.

Not less than thirty days prior to an involuntary transfer or discharge, a copy of the discharge plan shall be provided to the resident's personal physician or advanced practice registered nurse if the discharge plan was prepared by the medical director, to the resident and the resident's guardian or conservator, if any, or legally liable relative or other responsible party, if known.

In each case the facility shall prove by a preponderance of the evidence that it has complied with the sHB6317provisions /of Filethis No.section.

259Except 5in sHB6317the Filecase of an emergency or in LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-063175 of 10 R02-HB.docx } Substitute Bill No.

2596317 provisionscircumstances when the resident is not physically present in the facility, whenever the Commissioner of Social Services receives a request for a hearing in response to a notice of proposed transfer or discharge and such notice does not meet the requirements of subsection (c) of this section.section, the commissioner shall, not later than ten business days after the date of receipt of such notice from the resident or the facility, order the transfer or discharge stayed and return such notice to the facility.

Except in the case of an emergency or in circumstances when the resident is not physically present in the facility, whenever the Commissioner of Social Services receives a request for a hearing in response to a notice of proposed transfer or discharge and such notice does not meet the requirements of subsection (c) of this section, the commissioner shall, not later than ten business days after the date of receipt of such notice from the resident or the facility, order the transfer or discharge stayed and return such notice to the facility.

(2) The resident, the resident's guardian, conservator, legally liable relativeorotherresponsiblepartyshallhaveanopportunitytoexamine,relativeorotherresponsiblepartyshallhave anopportunitytoexamine, during regular business hours at least three business days prior to a hearing conducted pursuant to thissection,the contentsoftheresident's file maintained by the facility and all documents and records to be used by thecommissioner orthecommissioner'sdesigneeor thefacility atthe hearing.

A sHB6317hearing /shall Filebe held in accordance with the requirements of this LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06317-6 of 10 R02-HB.docx } Substitute Bill No.

2596317 6subsection sHB6317not Filelater No.than fifteen business days after the date of receipt of the request.

259 hearing shall be held in accordance with the requirements of this subsection not later than fifteen business days after the date of receipt of the request.

The Superior Court shall consider an appeal from a decision of the Department of Social Services pursuant to this section as a sHB6317privileged /case Filein order to dispose of the case with the least possible LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06317-7 of 10 R02-HB.docx } Substitute Bill No.

2596317 7delay. sHB6317 File No.

259 privileged case in order to dispose of the case with the least possible delay.

(b)A facility shallnot transfer or discharge aresident fromthefacilityfrom thefacility unless (1) the transfer or discharge is necessary to meet the resident's welfare and the resident's welfare cannot be met in the facility, (2) the transfer or discharge is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility, (3) the health or safety of individuals in the facility is endangered, (4) the resident has failed, after reasonable and appropriate notice, to pay for a stay or a requested service, at the facility or (5) the facility ceases to operate.

In the case of an involuntary transfer or discharge the resident and, if known, his legally liable relative, sHB6317LCO /{\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-063178 Fileof 10 R02-HB.docx } Substitute Bill No.

2596317 8guardian sHB6317or Fileconservator No.shall be given a thirty-day written notification which includes the reason for the transfer or discharge and notice of the right of the resident to appeal a transfer or discharge by the facility pursuant to subsection [(d)] (e) of this section.

259 guardian or conservator shall be given a thirty-day written notification which includes the reason for the transfer or discharge and notice of the right of the resident to appeal a transfer or discharge by the facility pursuant to subsection [(d)] (e) of this section.

(2) In an emergency the facility may request that the commissioner makeLCO a{\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06317-9 determinationof as10 toR02-HB.docx the} needSubstitute forBill an immediate transfer or sHB6317 / File No.

2596317 9make sHB6317a Filedetermination No.as to the need for an immediate transfer or discharge of a resident.

259 discharge of a resident.

2 from passage 19a-535a StatementHS ofJoint LegislativeFavorable Commissioners:Subst.

InPH SectionsJoint 1(f)(2)Favorable andLCO 1(f)(3),{\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-0631710 provisionsof were10 rewrittenR02-HB.docx for} clarity and internal consistency.