Resident Transfer from One Level of Care to Another Level of Care

Resident Transfer From One Level of Care to Another Level of Care 

Effective Date: [Original NPP Date] 

Revised Date: [Current Date] 

Goal 

To ensure all residents receive the appropriate level of care required. 

Policy 

I. When a resident’s level of care changes, the attending physician will write an order to transfer the resident to a different level of care (i.e., SNF, ICF) and document justification for such in the doctor’s progress notes. 

II. The physician must specify in the doctor’s orders: 

• For a Title XIX resident: “Continue all previous orders with the exception of now Certified for ICF/SNF level of care.” 

• For a private resident: “Continue all previous orders,” noting any changes, new orders, etc., for the resident. 

Note: If the doctor's orders are not on the same page as the above orders, all orders must be rewritten on a new page. 

III. The transferring charge nurse will document in the narrative nurses' notes the date, time, and transfer location. 

IV. For Title XIX residents, the charge nurse will complete a W-10, marking at the bottom the appropriate level the resident is being transferred to (SNF/ICF). The W-10 must be signed by the physician. A copy of the W-10 is maintained in the medical record, and a copy is sent to the Bookkeeping Department. 

V. The medical record, medications, kardexes, appropriate equipment, etc., are transferred to the new location with the resident. 

VI. The receiving charge nurse will document in the narrative nurses' notes the date, time, and unit from which the resident was transferred. 

References: 

• Centers for Medicare & Medicaid Services. State Operations Manual, Appendix PP - Guidance to Surveyors for Long Term Care Facilities. [Link to current CMS SOM] 

• CMS Requirements of Participation for Long-Term Care Facilities. [Link to current guidelines]