Termination can be a tricky issue. You may need to terminate care for a variety of reasons. It is important to know what the rules are in your state and what your ethics code says about what constitutes proper termination. Even if the patient terminates care or simply stops coming to sessions, you may be required to formally terminate care. Additionally, there may be times when you feel you have to terminate care immediately; for example, a safety concern. When possible, obtain expert consultation to determine if and how you can immediately terminate care. Always ensure that you memorialize the termination in writing and keep a copy in the patient's medical record.
There are often state requirements regarding mailing the termination letter. If you do not adhere to state requirements, you could face a licensing board complaint or even a lawsuit involving a claim of patient abandonment. As such, make sure that you are aware of the rules before you need to terminate. Even though it may not be required in your state, from a risk management view, best practice is to send the letter first class and a separate letter by certified mail, return receipt requested, to the patient’s last known address. Your state may not require both of these steps; however, it is important to show that you made efforts to contact the patient and it also provides additional proof of attempts.
Be sure to check your profession’s ethical guidelines on termination principles. When you have questions, it is best to consult an attorney for guidance.
Kristen Lambert, JD, MSW, LICSW, CPHRM, FASHRM
Healthcare Practice and Risk Management Innovation Officer
Trust Risk Management Services, Inc.
NOTE: This information is provided as a risk management resource and is not legal advice or an individualized personal consultation. At the time this resource was prepared, all information was as current and accurate as possible; however, regulations, laws, or prevailing professional practice standards may have changed since the posting or recording of this resource. Accordingly, it is your responsibility to confirm whether regulatory or legal issues that are relevant to you have since been updated and/or to consult with your professional advisors or legal counsel for timely guidance specific to your situation. As with all professional use of material, please explicitly cite The Trust as the source if you reproduce or distribute any portion of these resources. Reproduction or distribution of this resource without the express written permission of The Trust Companies is strictly prohibited.