The Right Way to Say Goodbye: Patient Discharge Done Right

There are several reasons why you might need to discharge a patient from your practice. Regardless of the reason, it's important to follow the appropriate steps to avoid being liable for patient abandonment. If you are discharging a patient from your own practice, you are responsible for ensuring that all necessary steps are taken and that you provide adequate care until the patient can transition to another provider.

If you are a provider employed by someone else and are leaving the practice, it is not your responsibility to notify your patients, as the practice is responsible for informing them or transitioning them to another provider within the practice. Employers who are unhappy with your resignation may claim you need to give more than two weeks' notice to prevent patient abandonment issues, but this is not true. Nevada is a right-to-work state, so you are not required to give any notice to an employer unless you have a contractual obligation for a specific time period. Its always best to give both your patient and your employer as much notice as possible but some situations do not warrant lengthy time frames.

🏥 1. Understand Nevada’s Legal Framework

Private Practice

• Under NRS 630.304(7), practitioners must provide “adequate” notice before terminating the patient relationship or ensure continued care is arranged. Failure to comply can result in disciplinary action

• Per NRS 630.3062, discharge details must be retained in the patient’s medical record .

📑 2. Develop a Standardized Discharge Process

a. Evaluate Discharge Needs Early

• At initial intake or diagnosis, assess whether follow-up care or community services are needed.

• Identify those at risk of complications or lacking adequate support.

b. Involve Qualified Personnel

• Assign discharge planning to registered nurses, certified social workers, or trained staff if needed but remember that if you are the provider it is ultimately your responsibility to ensure that all of the steps are completed.

c. Plan & Document

• Create a written discharge plan covering:

  • Medications, referrals, follow-up appointments

  • Required patient education and support services

  • Contact information and care coordination

• Ensure the plan is recorded in the patient's chart and explained verbally.

📣 3. Communicate Clearly with Patients

• Provide advance notice of discharge or practice closure, specifying effective date.

• Include:

  • Reason for discharge (e.g., relocation, non-compliance, termination of care)

  • Instructions for continuing care or care transition

  • How to access medical records or reach a covering provider 

• Offer at least 30 days’ notice when possible to allow patients time to transfer care.

🧾 4. Ensure Safe Transitions

• Coordinate referrals to another provider or facility, passing along relevant medical records (with authorization).

• Communicate directly with receiving provider when needed—especially for complex cases.

• Think of transitions as a continuum, not an endpoint.

💾 5. Document Thoroughly

• In the chart, record:

  • Discharge summary with diagnosis, care disposition, and follow-up

  • Notification of patient and/or caregiver

  • Copies of notices sent and date of communication

  • Any patient questions, refusals, or follow-through commitments

• Keep documentation for statutory retention periods.

🚨 6. Address Risk & Follow Regulations

• Be cautious if using third-party referral agencies; ensure they are licensed entities and coordinate effectively.

• Don’t delay patient discharge for administrative reasons—per NAC, planning must not cause undue discharge delays.

• Non-compliance (e.g., inadequate notice, missing summary, unsafe transfer) can trigger Nevada State Board discipline.

🧰 7. Discharging Versus Closing Practice

If you're closing your practice:

• Notify all patients in writing—explain timelines, refer to new providers, and specify record access.

• Consider a plan for medical records storage and patient inquiries.

• Ideally provide 60–90 days’ notice, though Nevada doesn’t specify an exact timeframe—it mandates “adequate” notice.

✅ 8. Checklist for Compliance

Step	Completed?
Discharge evaluation early	☐
Qualified planner assigned	☐
Written plan documented	☐
Patient informed in advance	☐
Support services arranged	☐
Follow-up refills/referrals	☐
Discharge summary filed	☐
Documents saved as required	☐

🧠 In Summary

1. Start early – discharge planning begins at intake or diagnosis.

2. Include qualified staff to evaluate and plan.

3. Document every step – keep charts thorough and accurate.

4. Communicate clearly with patients and other providers.

5. Comply with Nevada law—no undue delay; discharge summaries within 30 days; adequate notice required.

6. Handle practice closures with care—provide written notice, referrals, and records access.

7. Protect your license—failure to comply can lead to discipline from the Nevada State Board.

By establishing a formal, patient-centered discharge process aligned with NAC 449 and NRS 630, you ensure legal compliance, patient safety, and continuity of care—all vital to professional and ethical practice in Nevada.