(a) The director of a facility or service provider shall be responsible for any recommendation to discharge a patient against the patient's wishes. The director or their designee shall implement such recommendations only after the director:

1. (1) reviews the recommendation to discharge to ensure that the reason(s) is fair, not arbitrary or capricious, and is serious enough to warrant discharge;
2. (2) reviews and evaluates the patient's total response to treatment, in light of the recommendation to discharge;
3. (3) confers with staff at a multidisciplinary meeting to discuss the patient's response to treatment and the recommendation to discharge;
4. (4) confirms that, within reasonable clinical judgment, all incremental interventions have been tried and failed, including consideration of transfer to another provider;
5. (5) provides a written notice to the patient that indicates the reason(s) for the recommended discharge as well as required information on how to appeal;
6. (6) if the patient appeals, meets with the patient to conduct the appeal no sooner than 24 hours after provision of the notice, to allow the patient time to seek the advice of others, if desired, and discusses with the patient the reasons to implement or rescind the recommendation to discharge; and

7. (7) informs the patient in writing of the decision to implement or rescind the recommendation to discharge no later than 72 hours after the appeal is made;

   1. (i) if discharge is decided after the appeal, assures that the patient receives information about treatment and referral options, and connections to such referrals if desired;
   2. (ii) if rescission of the discharge is decided after the appeal, assure the patient full opportunity to continue treatment.