Transfer Discharge at Pagtanggi sa Readmit Unit
Ang Office of Administrative Hearings and Appeals (OAHA) ay may pananagutan sa paghatol ng mga apela ng mga residente na nahaharap sa isang pinasimulan ng pasilidad na paglipat o paglabas mula sa kanilang nursing facility, o na ang nursing facility ay tumangging muling tanggapin ang residente pagkatapos ng isang panahon ng pagkakaospital o therapeutic leave.
Transfer or Discharge Appeals (TDA)
Under federal and state law, when a nursing facility initiates the transfer or discharge of a nursing home resident, the resident has established rights that must be addressed in order to ensure that the discharge is fair and appropriate. An essential component to these rights is the right to request a hearing. Only the resident or a resident’s authorized representative may request a transfer/discharge hearing. Residents desiring a hearing should submit a request as soon as possible in order for a decision in the matter to be rendered before the proposed date of discharge.
Mga mapagkukunan
- 42 Kodigo ng Pederal na Regulasyon bahagi 483.15 – Mga karapatan sa pagpasok, paglilipat at pagpapalabas
- 42 Kodigo ng mga Pederal na Regulasyon bahagi 483.21(c) – Pagpaplano ng Paglabas
- California Code of Regulations, title 22, section 72527 – Patients’ Rights
- Direktoryo ng Local Ombudsman Programa
Mga Apela sa Pagtanggi sa Pagbasa (RTR).
Under federal and state law, when a resident is transferred to the hospital or approved for therapeutic leave, they have a right to return to the nursing facility after they are hospitalized or when the period of therapeutic leave has concluded. When the resident is hospitalized and the nursing facility refuses to readmit the resident, the resident may request a hearing. Only the resident or a resident’s authorized representative may request a RTR hearing. Preferably, an RTR hearing request is submitted to OAHA while the resident is still hospitalized. OAHA conducts RTR hearings only for those residents who wish to return to their nursing facility.
Mga mapagkukunan
- 42 Kodigo ng Pederal na Regulasyon bahagi 483.15 – Mga karapatan sa pagpasok, paglilipat at pagpapalabas
- 42 Kodigo ng mga Pederal na Regulasyon bahagi 483.21(c) – Pagpaplano ng Paglabas
- California Code of Regulations, title 22, section 72520 – Bed Hold
- California Code of Regulations, title 22, section 72527 – Patients’ Rights
- Kodigo sa Kalusugan at Kaligtasan ng California seksyon 1599.1
- Direktoryo ng Local Ombudsman Programa
Mga Pagdinig sa TDA at RTR
OAHA’s hearing officers conduct the TDA and RTR hearings. Generally, the hearing is held via telephone. The resident or his/her authorized representative must be present at the hearing.
The hearing officer controls the course of the proceedings, digitally records the hearing, and takes sworn testimony from participants who are in attendance. The burden of proof is on the nursing facility to present evidence to support that its action is appropriate and in compliance with prevailing federal and state law. The resident or his/her representative will have the opportunity to present testimony, including from witnesses that they compel to appear at the hearing. Only testimony that is relevant to the action will be allowed, at the hearing officer’s discretion. After conclusion of the hearing, the hearing officer writes the final administrative decision of the Department, known as a Decision & Order. The Decision & Order will either “grant,” “deny,” or “dismiss” the residents’ appeal and outline the remedy that has been ordered. RTR hearings that are granted in favor of the resident will require the facility to submit a Certification of Compliance with the Department of Health Care Services.
Mga mapagkukunan
- 42 Code of Federal Regulations (CFR), Section 431. Subpart E – Fair Hearings for Applicants and Recipients
- 42 Code of Federal Regulations part 435.923 – Mga Awtorisadong Kinatawan
- Sertipikasyon ng Pagsunod
Humihiling ng Pagdinig
Kapag nagsusumite ng kahilingan sa pagdinig, tatanungin ka ng isang kinatawan ng OAHA ng serye ng mga tanong. Upang maiwasan ang hindi kinakailangang pagkaantala, mangyaring magkaroon ng sumusunod na impormasyon na magagamit bago gawin ang iyong kahilingan:
- Buong pangalan at petsa ng kapanganakan ng apektadong residente
- The name of the resident’s nursing facility and address (if you have it)
- Ang pangalan ng ospital kung ang residente ay kasalukuyang isang inpatient
- If filing an appeal on behalf of a resident, be prepared to provide your contact information and information to demonstrate that you are authorized to make the hearing request. For example, the resident asked you to request the hearing on his or her behalf, or you have a Durable Power of Attorney for the resident’s health care.
- Para sa mga kahilingan sa TDA, mas mainam na magkaroon ng nakasulat na Notice of Transfer/Discharge available sa oras ng iyong tawag. Kung ang SNF ay hindi nagbigay sa iyo ng nakasulat na paunawa, hilingin sa kanila na gawin ito.
- Para sa mga kahilingan sa RTR, ibigay ang petsa ng iyong paglipat mula sa nursing facility patungo sa ospital at ang (mga) petsa na tumanggi ang nursing facility na muling tanggapin ka.
Ang isang kahilingan sa pagdinig ay kumpleto kapag ang lahat ng kinakailangang impormasyon ay natanggap. Aabisuhan ng OAHA ang residente at ang nursing facility nang nakasulat sa oras, petsa, at lokasyon ng pagdinig.
To request a hearing, residents or their authorized representative can contact OAHA via telephone at (916) 445-9775, fax at (916) 440-5105, or email at OAHAefax@dhcs.ca.gov, or by using the OAHAE-Filing Portal (coming soon).