The Medical Review Board (MRB) recently discussed patients who are involuntarily discharged by their physicians. The MRB acknowledges that physicians can discharge patients without the consent of The Renal Network or the staff at the unit. However, the attending physician is required to follow the unit’s involuntary discharge process which should include the IVD process[PDF, 79.3 KB] that is outlined in the Conditions for Coverage (494.180). The medical director is required to be involved in all discharges and the MRB recommends that medical directors reinforce V760 and V 763 of the State Guidance for the Conditions for Coverage [PDF, 82.1KB]. In addition, medical directors need to educate their attending physicians on the policies regarding involuntary discharges and to make them aware of the resources available from the staff that also can assist them with challenging situations to avoid discharging patients whenever possible.