Court Sets Out Rules for When Judge May Order Patient Admitted to Nursing Home

A Massachusetts appeals court rules that a judge cannot order a patient to be admitted to a nursing home unless the judge finds that the patient is an incapacitated person and appoints a guardian and then grants the guardian specific authority to admit the incapacitated person to a nursing home after finding that such admission is in the incapacitated person's best interest. Guardianship of D.C. (Mass. Ct. App., No. SJC-12390, May 11, 2018).

D.C. was admitted to the hospital with a fractured hip, among other issues. The hospital requested a guardianship, claiming that she was incapacitated based on her refusal of medical care and asked that D.C. be moved to a nursing home.

The trial court judge ruled that the hospital had failed to prove D.C. was incapacitated. He also reported questions to the appeals court, asking whether a guardian is necessary before D.C. can be admitted to a nursing home and whether the court had authority to appoint a limited guardian for the purposes of admitting D.C. to a nursing home.

The Massachusetts Court of Appeals rules that even though the trial judge did not properly report the questions, the court will answer because the questions raise important public interest considerations. The court holds that a "judge does not have the authority under [state law] to allow a hospital's request to admit a patient to a skilled nursing facility against the will of the patient where, as here, the judge has not found the patient to be an incapacitated person and, therefore, has not appointed a guardian for that patient." In addition, the court rules that even if D.C. was found to be incapacitated, the guardian would not have the authority to admit D.C. to a nursing facility unless the judge granted the guardian that specific authority after finding it was in D.C.'s best interest.

For the full text of this decision, go to: https://www.mass.gov/files/documents/2018/05/11/12390.pdf

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