Approximately 16,500 people live in nursing homes in South Carolina. The AARP Scorecard ranks South Carolina 49th of 50 U.S. states for the availability of long-term care services and support for seniors. Still, many South Carolina seniors rely on nursing homes to meet their daily living and medical needs.

A nursing home resident may want to sign themselves out of a nursing home. If you’re a family member, you may wonder if you can sign someone out of a nursing home or if your loved one can sign themselves out.

Our experienced Greenville nursing home abuse lawyer at Bobby Jones Law explains.

Can You Just Sign Yourself Out of a Nursing Home in SC?

It depends. Generally, living in a nursing home is a choice. If the person is in good health, they can take a leave of absence to visit family or go to a medical appointment. They can also move themselves out permanently.

But there are two situations where it may not be as simple.

A guardian has been appointed

If the person has an appointed guardian, the guardian decides if the person can leave the nursing home. In South Carolina, a guardian is appointed by the probate court and makes decisions for someone’s care when the person cannot make decisions on their own.

Tip: There are many alternatives to guardianship and ways that care can be managed for seniors and vulnerable adults. The person may have a durable power of attorney, a health care power of attorney, or informal help from family and friends. It’s important to fully understand the legal situation, if there officially is one, and what authority allows others to make decisions for a nursing home resident.

Against Medical Advice

There may be a situation where doctors don’t think it’s a good idea for a nursing home resident to leave the facility, but the person insists on leaving. This is referred to as a discharge against medical advice (AMA). According to the National Institutes of Health, one to two percent of medical nursing home admissions result in an AMA discharge.

If the person is of sound mind and determined to leave, the nursing home can’t stop them. The person still has the right to leave, but the nursing home must take steps to document that the discharge is against medical advice.

The nursing home must provide the person with sufficient information to make their own informed decision. They must be told about the potential risks of leaving, the consequences, and the alternatives. The nursing home must carefully document that the person is making an informed decision to leave. In addition, the nursing home should work with specialists to ensure that the person is making the decision freely and with a sound mind.

Understanding Resident Rights in South Carolina Nursing Homes

Insurance coverage may restrict the person from leaving the facility. A person may have the right to leave, but doing so could jeopardize their insurance coverage.

Tip: Nursing homes commonly have notice requirements when someone chooses to move out. If you don’t give the required notice, you may have to pay an extra fee (S.C. Code § 44-81-40(E)(1)-(2)).

Can Someone With Dementia Legally Leave a Facility?

No. A person with dementia who lives in a facility will likely have a guardianship in place. The guardianship allows the appointed person to make decisions about the person’s care. The resident may leave temporarily for a medical appointment or for personal reasons with permission and a care plan. However, if a person has dementia, the person is likely not of a sound mind to decide to leave on their own.

Medical Criteria for Discharge Against Medical Advice (AMA)

A discharge against medical advice occurs when:

The patient asks to be discharged
Full evaluation, treatment, and discharge planning haven’t happened yet
Evaluation, treatment, and discharge can’t happen on an outpatient basis
The person can make their own decision to leave

South Carolina nursing home regulations require a discharge plan to be in writing at the time of admission. The plan must include conditions under which the resident may be discharged. The plan must also provide for the disposition of personal property.

Liability and Risk When a Resident Leaves a Facility Prematurely

A nursing home facility can be held liable when a patient leaves against medical advice. Typically, people who choose to leave against medical advice have poor health outcomes. Documenting informed consent can protect a facility against legal liability.

Even if the nursing home has the person sign a form, that alone may be insufficient to shield them from liability. The nursing home may be liable if the person wasn’t of sound mind. The nursing home may be liable if it didn’t give the person the information needed to make an informed choice.

When Family Members Can or Cannot Prevent a Discharge

Just as you cannot force an elderly person into a nursing home, you may not be able to prevent them from leaving. If the person is of sound mind, your options to stop them from leaving are limited.

Family members can prevent a discharge if there is a guardianship, conservatorship, or power of attorney that allows them to exercise authority. A health care power of attorney in South Carolina typically covers discharge from a facility, including against medical advice (S.C. Code § 62-5-504).

If the person is not of sound mind, you must involve a court to declare that the person is not of sound mind. The nursing home may be able to hold the person temporarily while seeking an order from a probate court. A more formal hearing will follow soon. If you have concerns about the person’s immediate safety or the safety of others, you may call 911. You may also involve Adult Protective Services (APS), although they do not have a direct path to force someone to stay in a nursing home. Court involvement will be required.

Best practice

All adults need estate planning. It’s never too early.

If a person becomes incompetent without having estate planning in place, you can take the steps to have a guardian appointed. Then, if a person wants to leave a facility, you’re ready to step in and protect them.

If there is no estate planning in place and a person wants to leave a nursing home, you must work quickly to involve the courts for the person’s own protection.