St. John of God Retirement & Care Center v. Dept. of Health Care Services Office (Aug. 17, 2016, B265488) __ Cal.App.4th __ [2016 WL 4379335]
Plaintiff Gloria Woods was a resident of St. John of God Retirement & Care Center (St. John), a skilled nursing facility. She elected hospice care through St. Liz, a provider under contract to St. John. When Woods experienced a psychotic episode, St. Liz transferred her to an acute care hospital. After her hospital treatment concluded, St. John refused to readmit Woods to the first available bed, contending that it was not required to do so under 42 Federal Code of Regulations, section 483.12 (section 483.12), because St. Liz, not St. John, had ordered her hospitalization. Following an administrative hearing, the Department of Health Care Services (DHCS) ordered St. John to readmit Woods. The superior court denied St. John’s petition for writ of administrative mandate, and St. John appealed.
The Court of Appeal affirmed, holding that section 483.12 does not exempt a skilled nursing facility from the readmission requirement “solely because the transfer to an acute care hospital from which the resident is returning was ordered by the resident’s hospice care provider rather than the facility itself.” As a result, St. Liz’s initiation of the acute hospitalization also did not exempt St. John from complying with section 483.12 provisions regarding (a) identification and documentation of a justifying circumstance, (b) the preparation and orientation for a safe and orderly transfer, and (c) notice regarding the date of the transfer or discharge and the new resident location. The court explained that “Section 483.12 expressly refers to the obligations the facility bears to a ‘resident,’ and does not contain any suggestion that if the resident is under the care of a hospice provider, the involuntary transfer provisions do not apply.” The Court reasoned that “federal regulations would not deprive such a resident of the protections of section 483.12 simply based on whose employee – the hospice’s or the facility’s –determines the need for a transfer.”
Thomas Watson
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Horvitz & Levy LLP
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