MassHealth Fair Hearing Rights

In new MassHealth regulations that became effective on April 1, 2002, nursing home residents now have the right to appropriate notice and a MassHealth "fair hearing" if a nursing facility refuses to readmit them after a hospitalization. In this situation, the nursing home resident may request an expedited appeal which will be held as soon as possible, but within 7 days of request. The final decision is rendered within an additional 7 days. There are specific circumstances and procedures that have long been required before a nursing facility could transfer or discharge a patient. Some examples include a required physician’s order, notice to the patient and family about rights to a fair hearing and how to contact the nursing home ombudsman. These new regulations clarify that "a nursing facility’s failure to readmit a resident following a medical leave of absence shall be deemed a transfer or discharge" and therefore subject to these rules.