Montana Mediation Association (MtMA) received a Civil Monetary Penalty Reinvestment Grant to delay and possibly prevent resident discharges from Montana Nursing Homes. Starting Aug. 1, 2019, families, residents, and facilities may use Certified Elder Care Mediators to resolve problems addressing such discharges.

Historically, nursing homes have issued 30-day discharge notices to residents who are struggling to live in the nursing home. These struggles may stem from many different issues such as, failure to pay the bill, failure to comply with facility rules, inadequate or inappropriate levels of care, inability or unwillingness to follow physician orders, and an inability to get along with staff and/or other residents.

Appeal processes are available to residents through the Office of Fair Hearing; however, the appeal process generally exceeds the 30-day discharge notice protocol.

Obtaining legal assistance, filing the appeal, and negotiating a solution between the nursing home and the resident/family may not be feasible due to cost, time, inexperience in negotiating under such circumstances, and/or the fear of uncertainty meeting needs viably and in a timely manner.

Many residents, family members, and facility staff create bonds during the resident’s stay. The resident may desire to remain in place, even if conflicts arise. Facility staff, residents, and family often collaborate positively. Unfortunately, facility staff are limited to resolving problems based on the protocols available to them. Staff may feel as if there is no other option to resolve the conflict outside of issuing a 30-day discharge notice.

Elder Care Mediation is an option outside of the regulatory agencies’ protocols and/or litigation. Mediation allows the resident/family and facility to come together with a professional mediator who facilitates a conversation among the parties. The parties explore and identify issues together and address possible solutions that will work for all involved. As a result, the parties may move forward in creating a plan of action that is sustainable and fluid as needs change. As such, mediation can be scheduled quickly, confidentially, and informally as the parties’ desire.

Scheduling a mediation does not preclude investigations, legal counsel, or notification of discharge. Mediation effectively mitigates, de-escalates, and reinstates respectful communication and, ultimately, conflict resolution. Through the CMS Reinvestment grant, $5,000.00 has been made available to provide Elder Care Mediation services in order to delay and/or prevent discharges from nursing homes in Montana. Specific criteria must be met to utilize this grant money.

To find out more, contact the Montana Mediation Association at 406-579-2371, or email the association at You may also visit the website at to learn more about Elder Care Mediation, how it can help resolve problems in a nursing home, and how to qualify for services.

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