A resident may be transferred (discharged) from one level within the CCRC to another if his or her care needs change. Usually the admission contract describes the conditions under which the facility can require, and accommodate, this change in living area.
A resident would move to another section of the CCRC if he or she required more (or less) care than could be provided in the current section. The move to a more highly staffed section might be required if the resident developed:
- Mental confusion
- A pattern of falls
- The inability to independently perform activities of daily living (ADLs), such as getting out of bed, bathing, dressing, toileting, feeding oneself
- Other conditions that may endanger the resident or other residents
The Interdisciplinary Team
Usually the interdisciplinary team, which consists of physicians, nurses, social workers and therapists, will meet with the resident (and family, if appropriate) to discuss the overall situation if a resident is experiencing a change in functional ability. The team is responsible for determining if the resident needs to move to a different level of care.
Refusal to Move
The move to an area with less staff might be required if the resident's mental or physical status improved, and less nursing care or less assistance with personal care is needed. If the resident refuses to move, some CCRCs state in the contract that the resident will be discharged.
Moving to a different level within the retirement community may have a financial impact, depending upon the type of contract signed. Different types of contracts cover the cost of services in assisted living and nursing care in very different ways.
Financial Impact For Couples
If one member of a couple must move to another section, the couple may be billed for the two separate living areas, depending on the type of contract signed.
Discharge from the CCRC
The CCRC contract will define any conditions under which a resident may be discharged by the facility. Many CCRCs will discharge a resident who refuses to move to a higher level of care if the patient care team has recommended the move because the resident is a danger to himself, herself or others.
There may be other reasons that a resident chooses to leave the CCRC. Before admission, carefully review the portion of the contract that addresses under what circumstances, if at all, the entrance fee is refundable. The amount of the refund is based on a calculation dictated by Maryland regulations.