转移出院并拒绝重新入院单位
行政听证和上诉办公室 (OAHA) 负责审理因机构原因被转出或出院的居民的上诉，或因护理机构拒绝在住院或治疗假结束后重新接收居民的上诉。
调职或解除上诉 (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.
资源：
- 42 联邦法规第 483.15 部分 – 入院、转院和出院权利
- 42 联邦法规第 483.21(c) 部分 – 出院计划
- California Code of Regulations, title 22, section 72527 – Patients’ Rights
- 地方监察员计划目录
拒绝重新接纳 (RTR) 上诉
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.
资源：
- 42 联邦法规第 483.15 部分 – 入院、转院和出院权利
- 42 联邦法规第 483.21(c) 部分 – 出院计划
- California Code of Regulations, title 22, section 72520 – Bed Hold
- California Code of Regulations, title 22, section 72527 – Patients’ Rights
- 加州健康与安全法规第 1599.1 条
- 地方监察员计划目录
TDA 和 RTR 听证会
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.
资源：
- 42 Code of Federal Regulations (CFR), Section 431. Subpart E – Fair Hearings for Applicants and Recipients
- 42 联邦法规第 435.923 部分 – 授权代表
- 合规性认证
请求听证
提交听证请求时，OAHA 代表会询问您一系列问题。为了避免不必要的延误，请在提出请求之前准备好以下信息：
- 受影响居民的全名和出生日期
- The name of the resident’s nursing facility and address (if you have it)
- 如果居民目前是住院患者，则提供医院名称
- 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.
- 对于 TDA 请求，最好在致电时准备好书面的转移/解除通知。如果 SNF 没有向您提供书面通知，请要求他们这样做。
- 对于 RTR 请求，请提供您从护理机构转移到医院的日期以及护理机构拒绝重新接收您的日期。
当收到所有必要的信息时，听证请求即完成。OAHA 将以书面形式通知居民和护理机构听证会的时间、日期和地点。
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).