Understanding F627: Inappropriate Transfers and Discharges

Inappropriate transfers and discharges continue to be a significant concern for long-term care facilities, as they directly impact resident safety, dignity, and continuity of care. The Centers for Medicare & Medicaid Services (CMS) has addressed these issues through F627, which specifically targets noncompliant transfer and discharge practices. This blog explores the critical components of F627 and provides guidance on how facilities can ensure compliance and protect resident rights.

What Is F627?

F627 governs the inappropriate transfer or discharge of residents from long-term care facilities. This regulation ensures that residents are not moved without proper justification, advance notice, and comprehensive planning. The rule also protects residents from involuntary discharges that could negatively impact their health and well-being.

Key Provisions of F627

1. Acceptable Reasons for Transfer or Discharge:
   Facilities may only initiate a transfer or discharge if:

• The transfer is necessary for the resident’s welfare and the facility cannot meet the resident’s needs.
• The resident’s health has improved sufficiently so they no longer require the services provided by the facility.
• The safety of other residents is at risk due to the resident’s behavior.
• The resident fails to pay (or have payment made on their behalf) for their stay after reasonable notice.
• The facility is closing down or ceasing operations.

1. Prohibition of Noncompliant Discharges:
   Facilities are prohibited from discharging residents due to factors like staff convenience, behavioral challenges without proper assessment, or failure to explore reasonable accommodations. Additionally, discharges during pending Medicaid applications are considered noncompliant.
2. Advance Notice and Documentation:
   Residents and their representatives must receive a 30-day written notice before discharge, except in emergencies. This notice must outline:

• The reason for discharge.
• The effective date.
• Information on the resident’s right to appeal the decision.

Avoiding Noncompliance

• Comprehensive Assessments: Conduct regular and thorough assessments to identify if the facility can meet a resident’s evolving needs.
• Explore Alternatives: Engage in care planning and involve interdisciplinary teams to find solutions before considering discharge.
• Training and Policies: Educate staff on the requirements of F627 and establish clear discharge policies that align with CMS guidelines.

Why F627 Matters

By adhering to F627, facilities can reduce the risk of citations, protect residents’ rights, and promote a higher standard of care. Addressing inappropriate discharges fosters trust with residents and their families and ensures better health outcomes.

Ensuring compliance with F627 not only protects residents but also strengthens the facility’s reputation and operational integrity. Facilities that prioritize proper transfer and discharge practices demonstrate their commitment to resident-centered care and continuous quality improvement.

Book a Free Consultation