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Hospital Discharges

 

Sometimes there can be disagreement about when a patient is ready to be discharged from the hospital. Patients and/or their families may believe that they are not well enough to leave hospital care or that they are being discharged to a place where they cannot get the health care that they need.

The following will briefly summarize important laws and regulations that govern hospital discharges of patients in New Jersey. The legal citations to locate these laws for their exact language are included.

Who decides when a patient should be discharged from the hospital?

New Jersey requires that hospital patients may be discharged only on the order of the patient’s attending physician. A nurse or a social worker or another health care professional cannot make the decision to discharge a patient who has been admitted to the hospital. If the patient’s attending doctor does not agree that the patient is ready to be discharged, the hospital cannot discharge the patient.

Note that a patient can leave the hospital against a doctor’s advice. But the patient will be asked to sign a waiver that says the doctor will not be at fault if the patient is harmed as a result of leaving the hospital against medical advice. (N.J.A.C. 8:43G-5.2(d); 8:43G-11.5.)

Who decides where the patient should go after being discharged?

Hospitals must have a discharge team that is responsible for discharge planning. The team must include a social worker and a registered professional nurse. The discharge team must get input from the patient’s attending doctor, the staff nurse or other nurses, and other health professionals.

The discharge team must also work with the patient, if possible. And with the patient’s permission, the team will also meet with the patient’s family or significant other to develop an appropriate discharge plan for the patient. (N.J.A.C. 8:43G-11.4, 5[d].)

Can the hospital discharge a patient to anyplace?

The hospital must find an “appropriate” placement for a patient who needs further care. This may mean a rehabilitation facility, a nursing home, the patient’s home with the assistance, or any other “appropriate” placement. (N.J.A.C. 8:43G-11.5.)

A patient who has no way to get necessary home health care from an agency may not be discharged to his or her home if the patient alone or his or her spouse or other family members are unable to provide adequate care. Family who are not able to provide the necessary health care in their home for the patient may refuse to let the hospital discharge the patient to them. In that case, the hospital still must find an “appropriate” placement for the patient’s discharge.

Please note that, in most cases, hospitals’ social workers, nurses, and other health professionals on discharge teams are very familiar with all the health care resources in their community. They consistently find appropriate placements for discharged patients who need further care.

However, if you are dissatisfied with the hospital’s actions and you are unable to resolve the problem with the hospital’s administrators, you may complain to the NJ Department of Health and Senior Services. This is the state agency that licenses hospitals and other health care facilities in New Jersey. You can contact them through their 24-hour Complaint Hotline at 1-800-792-9770 or at the Division of Health Facilities Evaluation and Licensing's Complaints and Hotlines page.

You may also contact your nearest Legal Services office or call LSNJ-LAW™, Legal Services of New Jersey’s statewide, toll-free legal hotline, at 1-888-LSNJ-LAW (1-888-576-5529) to see if you are eligible for free legal assistance. Hotline hours are Monday through Friday, 8:00 a.m. to 5:30 p.m. If you are not eligible for assistance from Legal Services, the hotline will refer you to other possible resources.

This information last reviewed 10/26/11

 

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