                                 CODE OF VIRGINIA

IMPLEMENTATION OF TRANSFER AND DISCHARGE POLICIES (§ 32.1-138.1)

A. To implement and conform with the provisions of subdivision A 4 of §
32.1-138, a facility may discharge the patient, or transfer the patient,
including transfer within the facility, only:

   1. If appropriate to meet that patient&#8217;s documented medical needs;

   2. If appropriate to safeguard that patient or one or more other patients from
   physical or emotional injury;

   3. On account of nonpayment for his stay except as prohibited by Titles XVIII
   or XIX of the United States Social Security Act and the Virginia State Plan
   for Medical Assistance Services; or

   4. With the informed voluntary consent of the patient, or if incapable of
   providing consent, with the informed voluntary consent of the patient&#8217;s
   authorized decision maker pursuant to &#xA7; 54.1-2986 acting in the best
   interest of the patient, following reasonable advance written notice.

B. Except in an emergency involving the patient&#8217;s health or well being, no
patient shall be transferred or discharged without prior consultation with the
patient, the patient&#8217;s family or responsible party and the patient&#8217;s
attending physician. If the patient&#8217;s attending physician is unavailable,
the facility&#8217;s medical director in conjunction with the nursing director,
social worker or another health professional, shall be consulted. In the case of
an involuntary transfer or discharge, the attending physician of the patient or
the medical director of the facility shall make a written notation in the
patient&#8217;s record approving the transfer or discharge after consideration
of the effects of the transfer or discharge, appropriate actions to minimize the
effects of the transfer or discharge, and the care and kind of service the
patient needs upon transfer or discharge.

C. Except in an emergency involving the patient&#8217;s health or well being,
reasonable advance written notice shall be given in the following manner. In the
case of a voluntary transfer or discharge, notice shall be reasonable under the
circumstances. In the case of an involuntary transfer or discharge, reasonable
advance written notice shall be given to the patient at least five days prior to
the discharge or transfer.

D. Nothing in this section or in subdivision A 4 of &#xA7; 32.1-138 shall be
construed to authorize or require conditions upon a transfer within a facility
that are more restrictive than Titles XVIII or XIX of the United States Social
Security Act or by regulations promulgated pursuant to either title.

HISTORY: 1987, c. 221; 1993, c. 692.