Although most people move from their home or an assisted living facility (ALF) to a nursing home, in a minority of cases, the move happens in reverse. In those cases, when a person’s physical or mental functions improve, it is sometimes possible for a nursing home resident to transition back into the community, either at home or in an ALF.
The greatest obstacle to returning to the community, other than an individual’s physical or mental condition, is the cost of care. Under the 1999 United States Supreme Court case of Olmstead vs. Zimring (527 U.S. 481), the Supreme Court held that institutionalization based on disability, when a person qualified for in-home care that was readily available, amounted to discrimination by segregation in violation of Title II of The Americans With Disabilities Act (ADA). Accordingly, Florida enacted F.S. 430.7031 in 2002. This statute authorized The Agency For Health Care Administration (AHCA) and The Department of Elder Affairs (DOEA) to create a procedure for persons in nursing homes to transition back into the community with priority placement for services, if they could function in a less costly setting than a nursing home.
As a result of the above Florida statute and subsequent litigation, AHCA and DOEA developed a procedure known as “The 60-day Transition Rule.” This rule allows for services to be provided to a person who can transition from a nursing home to an ALF or back home after spending 60 consecutive days in the nursing home on Medicaid. The most significant aspect of this rule is that the person does not have to go on a waiting list as is the normal procedure to obtain Home and Community Based Services (HCBS), which in some cases take more than one year.
Unfortunately, most of the available information on this program is incorrect, and in most cases, persons who could avail themselves of this program do not even know it exists.
While Elder Law Attorneys have helped many persons transition back into the community under this program, AHCA and DOEA need to disseminate better and more accurate information on this program to Nursing Homes, Assisted Living Facilities, Aging Resource Centers, and Community Centers.
If this program can help you or a loved one transition from a nursing home back to the community, contact The Elder Law Center of Mondschein and Mondschein, P.A. for assistance. As an Elder Law firm with a Board Certified Elder Law Attorney on staff, we can guide you through this process and help bring you or your loved one back into the community.
F.S. 430.7031 was repealed in October, 2013. The future of the 60-day Transition Rule is unclear as of January, 2016. However, as of this date, the 60-day Transition Rule seems to be in operation.
If you want more information about the Nursing Home Transition Program, call our Miami office for a free telephone consultation: (305) 274-0955.