(1) The resident has the following transfer and discharge rights. Transfer and discharge includes movement of a resident to a bed outside of the swing-bed hospital facility whether or not that bed is in the same physical plant. Transfer and discharge does not refer to movement of a resident to a bed within the same certified facility.

(2) The facility must permit each resident to remain in the facility and may not transfer or discharge the resident from the facility unless any one or more of the following apply:

(a) the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;

(b) the transfer or discharge is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility;

(c) the safety of individuals in the facility is endangered;

(d) the health of individuals in the facility would otherwise be endangered;

(e) the resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under medicare or medicaid) a stay at the facility. For a resident who becomes eligible for medicaid after admission to a facility, the facility may charge a resident only allowable charges under medicaid;

(f) the facility ceases to operate; or

(g) an appropriate nursing facility bed is available within a 25 mile radius of the swing-bed hospital, as provided in ARM 37.40.405.

(3) When the facility transfers or discharges a resident, the facility must document the reason for transfer or discharge in the resident's clinical record. The documentation must be made by the resident's physician when transfer or discharge is necessary under (2) (a) and (b) , or a physician when transfer or discharge is necessary under (2) (d) .

(4) Before a facility transfers or discharges a resident, the facility must:

(a) notify the resident and, if known, a family member or legal representative of the resident of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand;

(b) record the reasons in the resident's clinical record; and

(c) include in the notice the items described in (6) through (6) (f).

(5) Notice of transfer or discharge must be made by the facility at least 30 days before the resident is transferred or discharged except when:

(a) the safety of individuals in the facility would be endangered;

(b) the health of the individuals in the facility would be endangered;

(c) the resident's health improves sufficiently to allow a more immediate transfer or discharge;

(d) an immediate transfer or discharge is required by the resident's urgent medical needs;

(e) a resident has not resided in the facility for 30 days; or

(f) transfer is required within 72 hours because an appropriate nursing facility bed is available within a 25 mile radius of the swing-bed hospital. In such cases, the facility must provide notice within 24 hours of determining that the nursing facility bed is available.

(6) The written notice of transfer or discharge must include the following:

(a) the reason for transfer or discharge;

(b) the effective date of transfer or discharge;

(c) the location to which the resident is transferred or discharged;

(d) a statement that the resident has the right to appeal the action to the Fair Hearings Office at the Department of Public Health and Human Services;

(e) the name, address, and telephone number of the state of Montana long term care ombudsman in the Office on Aging, Senior and Long Term Care Division; and

(f) for nursing facility residents with developmental disabilities and nursing facility residents who are mentally ill, the mailing address and telephone number of the Montana Advocacy Program, Inc.

(7) A facility must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility.