La. Admin. Code tit. 48 § I-5649

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-5649 - Transfer and Discharge Requirements

A. Each provider shall develop, implement and comply with policies and procedures that address:

1. discharge;

2. transition to another level of care; and

3. transfer to another licensed provider.

B. The BHS provider shall ensure that a client is discharged:

1. when the clients treatment goals are achieved, as documented in the clients treatment plan;

2. when the clients issues or treatment needs are not consistent with the services the provider is authorized or able to provide;

3. according to the providers established written discharge criteria; or

4. when the voluntarily-admitted client, or clients parent or legal guardian, if applicable, requests discharge.

C. Discharge planning shall begin upon admission.

D. Discharge Plan. The provider shall submit a written discharge plan to each client upon discharge or, if unable to submit at discharge, within seven days after discharge. The discharge plan shall provide reasonable protection of continuity of services that includes:

1. the clients transfer or referral to outside resources, continuing care appointments, and crisis intervention assistance;

2. documented attempts to involve family or an alternate support system in the discharge planning process;

3. the clients goals or activities to sustain recovery;

4. signature of the client or, if applicable, the clients parent or guardian;

5. name, dosage, route and frequency of clients medications ordered at the time of discharge; and

6. the disposition of the clients possessions, funds and/or medications, if applicable.

E. Discharge Summary. The BHS provider shall ensure that each client record contains a written discharge summary that includes:

1. the clients presenting needs and issues identified at the time of admission;

2. the services provided to the client;

3. the providers assessment of the client's progress towards goals;

4. the discharge disposition; and

5. the continuity of care recommended following discharge, supporting documentation and referral or transfer information.

F. When a request for discharge is received or when the client leaves the provider against the providers advice, the provider shall:

1. have and comply with written procedures for handling discharges and discharge requests;

2. document the circumstances surrounding the leave; and

3. complete the discharge summary within 30 days of the clients leaving the program or sooner for continuity of care.

G. Transitions. When a client undergoes a transition to another level of care, the provider shall ensure that:

1. the transition to a different level of care is documented in the clients record by a member of the direct care staff;

2. the client is notified of the transition; and

3. if transitioning to a different provider, the staff coordinates transition to next level of care.

H. Transfer Process

1. If a residential provider decides to transfer a client, the provider shall ensure that there is an agreement with the receiving provider to provide continuity of care based on:

a. the compilation of client data; or

b. the medical history/examination/physician orders, psycho-social assessment, treatment plan, discharge summary and other pertinent information provided upon admission to inpatient or outpatient care.

2. The residential provider responsible for the transfer and discharge of the client shall:

a. request and receive approval from the receiving provider prior to the transfer;

b. notify the receiving provider prior to the arrival of the client of any significant medical and/or psychiatric conditions and complications or any other pertinent information that will be needed to care for the client prior to arrival;

c. transfer all requested client information and documents upon request; and

d. ensure that the client has consented to the transfer.

I. If a client is involuntarily committed to a provider, the provider shall:

1. maintain the care of the client until an appropriate level of care becomes available; and

2. comply with the transfer and discharge requirements in this Chapter.

La. Admin. Code tit. 48, § I-5649

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 411703 (9/1/2015).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2151-2161.