4.28 ICF – Discharge Procedure

Purpose

To identify the conditions under which participation in Open Door Intermediate Care Facility (ICF) is no longer appropriate and the procedure associated with the release of an individual from the facility. Individuals at an ICF must demonstrate benefit from active treatment services and not require long–term skilled nursing care.

Policy

Exit from the program may be based on the availability of alternative placement/residential options in the community as determined by the Franklin County Service Coordinator. Discharge should be considered when one or more of the following conditions are identified:

1. Based on the individuals’ needs and the interdisciplinary teams’ recommendation that an intermediate level of care is no longer needed or the individual no longer wants services.
2. The discharge is necessary for the individuals’ welfare and their needs can no longer be met without imposing undue hardship on the operation of the facility.
3. An emergency situation exists creating an unreasonable risk of harm to him/herself, other individuals, or staff.
4. Refusal or denial of payment for services by federal, state, or private sources.
5. The facility ceases to operate.

Procedure

The following procedures will be followed regardless of the specific reason for discharge; unless an emergency is determined to exist:

• The interdisciplinary team including the individual, and/or the guardian reaches a decision to pursue another place of residence.
• 30 days prior to discharge unless an emergency situation exists, the facility will notify the individual, advocate, parent (if applicable), guardian, and the county board in writing of the discharge. This notice will include actions taken to meet the individual’s needs, the reason for discharge, effective date, location, and the appeal process which includes the right to contact Ohio Legal Rights. The reasons for discharge will also be recorded in the individual’s record.
• The interdisciplinary team will meet and prepare a summary which includes:
  • Basic identifying information including the reason for initial referral to the program if known.
  • Recommendations pertaining to the individuals’ needs.
  • Name and location of the person and/or agency to be responsible for their future care.
  • The most recent PCP and evaluations.
• The PCP team will help the coordinator in the capacity needed to aid in a smooth transition of services.
• In the case of an emergency, the following procedure will be undertaken:
  • The Administrator in consultation with the appropriate facility staff will determine that an immediate need for discharge exists. An emergency is defined as:
    • Any situation creating a significant risk of harm to the individual or other individuals or staff in the residential facility if action is not taken.
    • An individual is admitted to a hospital and then released to a nursing facility or skilled nursing facility for continued medical care or rehabilitation indicating that the level of care has changed to that of a nursing facility level of care.
  • The Administrator or designee will notify the individual and/or guardian, and the county board of the need for immediate discharge in writing.
  • The general steps for discharge should be followed according to sections B – b. In the future, if condition(s) no longer exist that led to the emergency discharge, they may always return to the facility and be given top priority.

Appeal Process

1. Within seven days of receipt of the written notice of intent to discharge, the individual, guardian, parent, or advocate may appeal the decision in writing to the Chief Executive Director.
2. The appeal will be reviewed within five days from receipt and applicable parties will be notified in writing of the decision and reasoning within five days of this decision. The applicable parties may appeal this decision in writing to the Executive Director and the Ohio Department of Developmental Disabilities (DODD).
3. Within 15 days of receipt of the appeal, a mediation meeting will be scheduled for all applicable parties to try to attain a resolution prior to a hearing. If the parties are unable to come to an agreement, the DODD will convene a hearing panel within 15 days of the mediation and conduct a hearing.
4. The hearing officer will issue a written recommendation to the Executive Director of DODD within 10 days following the hearing. The Executive Director will then issue a written decision within five days of the recommendation and no later than 45 days from receipt of the request for a hearing.
5. These timelines may be extended if agreed upon by all parties involved.

Last Revised: 4/29/22