Summary of Transition Process — An Important Document for All of Us

The new summary of the Transitions Process, which deals with what happens when a question is raised about the appropriate level of care for a resident, is now fully in place.  It is so important  that we are posting the summary in full.  A link is also here.  The first para of the summary is so key, that I have chosen to italicize it.

Transition to a Different Level of Care at Collington

Resident Rights in Transition Decision-Making

Resident self-determination is the underlying goal of a level-of-care transition. When desired by the resident, residential facilities and services should be improved when appropriate and necessary to maintain an unchanged resident care status.

Transition decisions made in an emergency differ initially from those requested by a resident or recommended by staff in non-emergency situations. The non-emergency decision-making process is made by the Transition Committee*, while the emergency decision is made initially by staff and subsequently reviewed and modified if necessary by the Transition Committee. The resident rights specified below center on the Transition Committee decision-making process.

In the event a transition to a different level of care is requested by the resident or recommended by staff, the resident has the following rights:

  • The right to participate in the selection of a Case Reviewer to determine the appropriateness of a proposed transition
  • The right to attend and participate in the Transition Committee meeting at which staff will discuss the resident’s status and propose a plan
  • The right to designate up to two advocates to attend and participate in this meeting
  • The right to be accompanied by advocates when interviewed before, during, and after the Transition Committee meeting to assist the interviewer in understanding the resident’s wishes and to help the resident think through the various alternatives that may be discussed
  • The right to a full presentation of the Transition Committee’s proposed plan
  • The right to consider the proposed plan for up to a week before accepting or rejecting it
  • The right to reject the proposed plan, subject only to a proposed override by the Executive Director based on perceived danger to the health and safety of others. (Note: If the resident is deemed incompetent to make this decision, approval or rejection is required by the resident’s selected advocates. In this case, the resident’s Power of Attorney is required.)
  • The right to receive in writing the Executive Director’s proposed override decision
  • The right to appeal the Executive Director’s proposed decision within seven days of receipt.

NOTE: This summary of resident rights is based on the document titled POLICY AND PROCEDURES FOR TRANSITIONS AT COLLINGTON. The full policy document, located at, should be consulted for more specific information on all aspects of the transition process including both staff responsibilities and resident rights.


*The Social Services Director chairs the Transition Committee. Members include the Executive Director, Director of Health Services, Director of Nursing, Medical Director, Social Services Director, Social Services Independent Living Staff, Director of Dining Services, and a representative from Facilities.

3 thoughts on “Summary of Transition Process — An Important Document for All of Us

  1. Thank you,Richard, for posting the Transition Process. It was very helpful!

  2. Kudos to folks for helping to clarify ‘on paper’ this difficult issue . I see this as one of the ‘fuzzy areas’ in our life at Collington for many of us who are a bit confused about what and what not ‘continuing care’ in practice actually means.

    Another area in which I think some clarification would be helpful is to get a sense of just what we are responsible for in the care and maintenance of our cottages and gardens and what Collington is committed to take care of. Such as: periodically thorough cleaning including carpets, etc – interiors of refrigerators, ovens etc and so on. For me these at present are murky areas and I note that after nearly 6 years in my cottage some basic ‘maintenance’ along these lines would be welcome – and who to approach when ‘special maintenance’ is needed. Some of these items become more difficult to handle ourselves as we get older and less robust. (Perhaps the development of a new ‘handbook’ -or something similar – focused on these issues would be helpful.)

    Again thanks – and trust you are thoroughly enjoying this gorgeous day – cerulean skies with only wisps of airplane tracks to mar its perfection, infant buds on trees and shrubs beginning to emerge, etc and so on.

    So appreciate all that you and Joan to enhance our community in myriad ways.

    Jeanne Barnett – cottage 4005

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