Ky.gov
Effective: 4/15/2024

24.2 Alternate Care Facility Closure

Legal Authority

Introduction

​Adult protective services (APS) oversees adult placement and movement during the closure of a facility when the Center for Medicare and Medicaid Services (CMS) or the Office of the Inspector General determines that the facility will be closed, a court order is issued to close a facility or there is an emergency voluntary closure.​​​

Practice Guidance

  1. ​APS will meet with the residents and their families to:
    1. ​Explain that the Department for Community Based Services (DCBS) will assist with:
      1. ​Placement of resident into a new facility;
      2. Arranging transportation for residents to a new facility; and 
      3. Packing/transporting of personal belongings. 
    2. Request any preferences for facilities or location of placement within the state. 
  2. ​The resident or legal representative has the right to decline assistance from DCBS. 
  3. If the resident and/or legal representative has declined DCBS assistance, the SSW will:
    1. ​​Provide DCBS contact information for future assistance; 
    2. Offer to provide a list of care facilities within the state; and
    3. Follow up with the resident and/or legal representative after one (1) week to offer additional assistance. 
  4. The resident or legal representative must provide consent for referrals to be sent to prospective facilities.
  5. If requested, the APS Branch will ensure that the resident’s personal belongings are packed and transported.  
    1. ​DCBS will make reasonable efforts to transport the resident’s personal belongings on the day of discharge.  
  6. ​Allegations of abuse, neglect, and exploitation regarding adults in the facility will need to be sent to Central Intake (CI)and investigated by an SSW not participating in the closure process. 



​

Procedure

The SSW:

  1. Assesses the needs and wishes of the residents;
  2. Notifies family member(s), and/or legal representatives of the facility closure and discusses placement options;
  3. Assists in locating placement for each resident who has accepted DCBS services;
  4. Coordinates with nurse consultants/inspectors (NCI) to send referral packets to facilities as identified by the resident and/or legal representative; 
  5. Documents the following: 
    1. ​​The facilities that have been contacted;
    2. Referrals that have been sent; and 
    3. Any notice of acceptance or rejection, and instances of no bed availability. 
  6. Obtains the final confirmation from the resident and/or legal representative if an accepting facility has been found. 
  7. Arranges transportation of the adult;
    1. Negotiates transfer date and time with the receiving facility and the resident and/or legal representative; and
    2. Completes transportation form and forwards to the APS Branch (DCBSAdultProtection@ky.gov​).
    3. Completes a master register of all the adults who were placed as a result of the closure;
  8. Arranges for packing and transfer of personal belongings;
  9. Contacts the receiving facility no sooner than two (2) working days after placement to verify the successful transition and ensure there are no missing personal items or concerns to note;
    1. ​​​Completes the alternate care assessment upon successful placement.
​The NCI:
  1. In coordination with the SSW, will send referrals to facilities for review by copying/downloading and sending securely the following records:
    1. ​​Face sheet;
    2. Admission records;
    3. Diagnosis report;
    4. Immunizations records;
    5. Kardex report;
    6. Physician orders;
    7. Progress notes from past sixty (60) days;
    8. History and physical;
    9. Current medication administration record (MAR)/treatment administration record (TAR); and 
    10. Any other information requested by the receiving facility.​​



​

Contingencies and Clarifications

  • NCI is not responsible for reviewing, evaluating, or interpreting medical records for families or other facilities. 



Documents

Revisions

4/12/2024 Addition: 

​5. Documents the following: 

    1. ​​The facilities that have been contacted;
    2. Referrals that have been sent; and 
    3. Any notice of acceptance or rejection, and instances of no bed availability. 
​​9.  Contacts the receiving facility no sooner than two (2) working days after placement to verify the successful transition and ensure there are no missing personal items or concerns to not. ​

Contingencies and Clarifications

  • NCI is not responsible for reviewing, evaluating, or interpreting medical records for families or other facilities. ​​​


4/12/2024 Delete: 

  1. Completes the following steps during the closure process:
​7.  Copies and sends to the new facility the following items from the medical record:
    1. Face sheet;
    2. Advance directives;
    3. Pre-admission screening annual resident review (PASARR), if appropriate;
    4. TB testing;
    5. Physician's orders;
    6. Hospital discharge summary;
    7. History and physical;
    8. Other information requested by the receiving facility;
  1. ​​Contacts the adults’ payment source to advise of the new address;
  1. Arranges for packing and transfer of personal belongings;
  2. Arranges for packaging and transfer of medications; and

Coordinates the closure process with other agencies (i.e. the long-term care ombudsman, Department for Medicaid Services, Division of Family Support, and the Office of the Inspector General).