Nursing home “no returns” policy, when residents are discharged to the emergency department at 4 am: what does the law say?

Carmelle Peisah, Tiffany Jessop and Henry Brodaty
Med J Aust 2019; 210 (8): . || doi: 10.5694/mja2.50134
Published online: 6 May 2019

In reply: We thank Forbes and Ferraro for noting that rights around security of tenure in nursing homes apply equally to residents with mental illness as to those with dementia. As illustrated in the case presented by the authors, advocacy is particularly needed for residents with mental illness with the triple jeopardy of being aged, and having mental illness and dementia.1 A combination of stigma, lack of specialised expertise and inadequately resourced facilities may culminate in nursing homes seeking recourse to precipitous discharge for lack of other solutions, noting that hospitalisation rate per se is often used as a quality indicator of care in facilities.2 However, as we have previously noted, this practice is inconsistent with legislated guidelines under Division 2, User Rights Principles 2014 (section 96‐1, Aged Care Act 1997).3

  • Carmelle Peisah1
  • Tiffany Jessop1
  • Henry Brodaty2,3

  • 1 UNSW, Sydney, NSW
  • 2 Dementia Centre for Research Collaboration, UNSW, Sydney, NSW
  • 3 Centre for Healthy Brain Ageing, UNSW, Sydney, NSW



Our work in this area is supported by an Australian Government Dementia and Aged Care Services Fund grant.

Competing interests:

No relevant disclosures.


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