The facility must develop and implement written discharge policies and procedures that are in accordance with Arkansas Code § 20-10-1005 and include, at a minimum, the following:

1. (1) A client may be discharged only when:

   1. (A) The transfer or discharge is necessary to meet the resident's welfare, and the resident's welfare cannot be met in the facility;
   2. (B) The transfer or discharge is appropriate because the resident's health has improved sufficiently so that the resident no longer needs the services provided by the facility;
   3. (C) The transfer or discharge is appropriate because the resident is no longer benefiting from therapeutic programming;
   4. (D) The safety of individuals in the facility is endangered;
   5. (E) The health of individuals in the facility would otherwise be endangered;
   6. (F) The resident has failed, after reasonable and appropriate notice, to pay or to have paid under state-administered programs on the resident's behalf an allowable charge imposed by the facility for an item or service requested by the resident and for which a charge may be imposed consistent with federal and state laws and regulations; or
   7. (G) The facility ceases to operate;

2. (2)

   1. (A) The reasons for discharge of a client must be documented in the client’s permanent record and the discharge must be discussed with the client and his or her guardian or personal representative, who must be given a copy of the documentation setting forth the alternatives available.
   2. (B) This notice must be given thirty (30) days prior to the date of discharge.

   3. (C)

      1. (i) An immediate discharge for emergency on the grounds set forth in 20 CAR § 409-402(a) does not require that the facility provide notice of the discharge thirty (30) days in advance of the discharge.
      2. (ii) However, the facility shall provide the notice as soon as practicable.
      3. (iii) The facility shall document, prior to the discharge, the facts and circumstances leading to the emergency discharge;

3. (3)

   1. (A) “Medical reasons” for discharge must be based on the client’s needs and are to be determined and documented by a physician.
   2. (B) The client’s permanent record shall contain documentation of medical reasons for the discharge, including when discharge is immediate and due to emergency;

4. (4)

   1. (A) A written appeals process for clients objecting to discharge must be developed by the facility in conformity with Arkansas Code § 20-10-1002, as amended, as well as all applicable rules.

   2. (B) That process shall include:

      1. (i)

         1. (a) (a) The written notice of discharge must state the reason for the proposed discharge as documented in 20 CAR § 409-402(b).
         2. (b) (b) The notice must inform the client that he or she has the right to appeal the decision to the director within seven (7) calendar days.
      2. (c) (c) The client must be assisted by the facility in filing the written objection to the discharge;
      3. (ii) Within fourteen (14) days of filing of the written objections, a hearing will be scheduled;
      4. (iii) A final determination in the matter will be rendered within seven (7) days of the hearing; and
      5. (iv) The facility must provide assistance to clients to ensure safe and orderly discharge;
5. (5) The facility, in conjunction with the responsible party, must make arrangements to discharge clients who require a higher level of medical, nursing, or psychiatric care than can be safely and effectively provided in an adult day health care facility; and

6. (6)

   1. (A)

      1. (i) If the Office of Long-Term Care determines that a client is inappropriate for continued placement in the facility, the provider must arrange for discharge of the client within ten calendar (10) days of such notification or as otherwise specified by the office.
      2. (ii) Less time may be given by the office when a client’s life or health requires immediate medical attention.
   2. (B) The responsibility for the client’s care or lack of care shall rest with the provider.
   3. (C) If the office determines that the discharge of a client is necessary for reasons other than appropriateness of placement, the facility will have up to thirty (30) days to effectuate the discharge or as otherwise specified by the office.