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

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