A BILL TO BE ENTITLED
AN ACT clarifying hospital patient discharge rights and requiring hospitals TO provide a detailed statement of patient discharge rights at the time of admission.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 131E‑90 reads as rewritten:
"§ 131E‑90.  Authority of administrator; refusal to leave after discharge.
(a)	Except as provided in subsection (b) of this section, the case of a patient who refuses or fails to leave the hospital upon discharge by the attending physician shall be reviewed by two physicians licensed to practice medicine in this State, one of whom may be the attending physician. If in the opinion of the physicians, the patient should be discharged as cured or as no longer needing treatment or for the reason that treatment cannot benefit the patient's case or for other good and sufficient reasons, the patient's refusal to leave shall constitute a trespass. The patient shall be guilty of a Class 3 misdemeanor.
(b)	This section does not apply to patients who elect to exercise any of the applicable grievance or appeal rights described in G.S. 131E‑90.1 during the pendency of the grievance or appeal. If the final grievance or appeal decision is to discharge the patient and the patient refuses or fails to leave the hospital, the patient's refusal to leave shall constitute a trespass. The patient shall be guilty of a Class 3 misdemeanor."
SECTION 2.  Part 4 of Article 5 of Chapter 131E of the General Statutes is amended by adding a new section to read:
"§ 131E‑90.1.  Patient discharge rights; detailed statement of rights due upon admission.
(a)	Each hospital licensed under this Article shall, at the time of admission, provide to each patient or the patient's next of kin or other legally responsible representative a detailed statement of patient rights with respect to transfer and discharge. The statement shall include and inform the patient of at least all of the following:
(1)	When medically permissible, a patient may be transferred to another facility only after the patient or the patient's next of kin or other legally responsible representative has received complete information and an explanation concerning the needs for and alternatives to such a transfer. The facility to which the patient is to be transferred must first have accepted the patient for transfer.
(2)	Except for medical reasons, the patient's own or another patient's welfare, nonpayment for the stay, or when the transfer or discharge is mandated under Title XVIII (Medicare) or Title XIX (Medicaid) of the Social Security Act, each patient has the right not to be transferred or discharged from a facility without at least five days' advance written notice of a transfer or discharge in order to ensure an orderly transfer or discharge, unless the attending physician orders immediate transfer or discharge. All transfer and discharge decisions and the reasons for these decisions shall be documented in the patient's medical record. A patient or the patient's next of kin or other legally responsible representative may dispute a transfer or discharge decision as specified in subdivision (3) or (4) of this section, or both, as appropriate.
(3)	The patient has the right to file a complaint with the Division of Health Service Regulation Complaint Intake Unit about a transfer or discharge at any time. The hospital shall provide the patient with contact information for filing a complaint by telephone, facsimile, or mail.
(4)	A patient who is a Medicare beneficiary has the right to all of the following:
a.	An explanation of the patient's hospital inpatient rights under Medicare, including the right to receive Medicare covered services, be involved in any decisions about the patient's hospital stay, and information about who will pay for any services the patient receives.
b.	Information in advance of the hospital furnishing or discontinuing care to the patient, whenever possible.
c.	An explanation of the patient's discharge rights under Medicare, including an explanation of the hospital's obligation to involve the patient and the patient's family in developing a discharge plan.
d.	An explanation of the process for filing with the hospital a verbal or written grievance or appeal regarding premature discharge and a process for prompt resolution of that grievance or appeal. The explanation must do all of the following:
1.	Inform the patient of the specific procedures to be followed in filing a grievance or appeal, which must specify (i) the time frames for review of the grievance and the provision of a response and (ii) the hospital's obligation to provide the patient with written notice of its decision that contains the name of the hospital contact person, the steps taken on behalf of the patient to investigate the grievance, the results of the grievance process, and the date of completion.
2.	Inform the patient how to contact the Quality Improvement Organization (QIO) to appeal a premature discharge.
3.	Inform the patient that, if a grievance or appeal is filed before the discharge date, the patient will not be responsible for paying for services received during the pendency of the grievance or appeal, except for charges such as co‑pays and deductibles.
(b)	No hospital licensed under this Article shall violate the rights described in subsection (a) of this section.
(c)	As used in this section, "Quality Improvement Organization" or "QIO" means the federal Centers for Medicare and Medicaid Services contractor charged with reviewing the appropriateness and quality of care rendered to Medicare beneficiaries in the hospital setting."
SECTION 3.  This act becomes effective October 1, 2017.