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

Malcolm P Forbes and Angelo Ferraro
Med J Aust 2019; 210 (8): . || doi: 10.5694/mja2.50132
Published online: 6 May 2019

To the Editor: We note with interest the letter from Peisah and colleagues.1 A group of oft‐forgotten patients also affected by “no returns” policies is older people with mental illness. We have recent experience of a 72‐year‐old man with diagnoses of schizoaffective disorder and Alzheimer dementia who was admitted to an aged mental health inpatient unit with a relapse of his schizoaffective disorder. He was admitted from a nursing home where he had resided for 4 years, during which time his illness had been stable except for an admission some 12 months earlier.


  • 1 Royal Melbourne Hospital, Melbourne, VIC
  • 2 University of Melbourne, Melbourne, VIC
  • 3 Aged Persons Mental Health Unit, NorthWestern Mental Health Service, Melbourne, VIC


Correspondence: malcolmpforbes@gmail.com

Competing interests:

No relevant disclosures.

  • 1. Peisah C, Jessop T, Brodaty H. Nursing home “no returns” policy, when residents are discharged to the emergency department at 4 am: what does the law say? Med J Aust 2018; 209: 324. https://www.mja.com.au/journal/2018/209/7/nursing-home-no-returns-policy-when-residents-are-discharged-emergency
  • 2. Grabowski DC, Aschbrenner KA, Rome VF, Bartels SJ. Quality of mental health care for nursing home residents: a literature review. Med Care Res Rev 2010; 67: 627–656.
  • 3. Lane A, McCoy L, Ewashen C. The textual organization of placement into long‐term care: issues for older adults with mental illness. Nurs Inq 2010; 17: 2–14.
  • 4. Li Y, Cai X, Cram P. Are patients with serious mental illness more likely to be admitted to nursing homes with more deficiencies in care? Med Care 2011; 49: 397–405.
  • 5. Hanif I, Rathod B. Delays in discharging elderly psychiatric in‐patients. Psychiatr Bull 2008; 32: 211–213.

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