Senate committee substitute makes the following changes to 3rd edition.
Amends GS 131D-2.1 to provide that the adult care home resident discharge team consists of one member (was, two) from the department of social services and one member from the designated local management entity (LME). Amends GS 131D-4.8, deleting provision directing the Hearing Unit to determine, in its discretion, an appropriate discharge destination within 60 days after the date of the resident’s discharge hearing. Directs the Department of Health and Human Services not to prohibit discharge solely because the Hearing Unit determines that the discharge destination (was, the discharge destination identified by the adult care home) in the required written notice does not include an appropriate discharge destination. Specifies residents’ primary unmet needs that require LMEs to take the lead role for the discharge destination of those patients, and those primary unmet needs that require the local departments of social services to take the lead role for the residents. Also provides that when the facility convenes the adult care home resident discharge team, that discharge team is to consult with the facility, as well as the resident receiving the discharge notice and that resident’s legal representative. Adds additional criteria and rights regarding the resident’s discharge. Clarifies that when a discharge is under appeal, the resident is to remain in the facility and not be subject to discharge until the Hearing Unit issues a decision; however, provides a list of exceptions to this provision. Deletes as a basis for convening the adult care home resident discharge team the finding by the resident that the destination is unacceptable. Also provides that a discharge is not subject to appeal because a resident’s physician requires a different level of care unless there is a documented conflict between two or more of the resident’s physicians regarding the resident’s appropriate level of care.

House amendments make the following changes to 2nd edition. Amendment #1 creates new subsection (g) to GS 131D-4.8 providing that if a discharge is under appeal or if the adult care home resident discharge team has been convened and no decision has been made, the resident will remain in the facility and is not subject to discharge until an appropriate discharge destination that is acceptable to the resident is located.
Amendment #2 amends GS 131D-4.8(b) to clarify that upon arrival at any adult care home, an individual must be identified to receive a discharge notice on behalf of the resident. Provides that an adult care home must notify a resident, the residents legal representative, and the individual identified to receive a discharge notice of its intent to initiate discharge of the resident, in writing, at least 30 days before discharge.