While the laws in your state may be different, a physician can discharge a mentally competent patient from a hospital to another facility such as a nursing home with the patient's consent and not discuss the same or get the consent of the family. A physcian can also suggest and make arrangments for a mentally competent patient to be admitted to a nursing home directly from the community with the patient's consent and not discuss the same or get the consent of the family. Notwithstanding, it is the usual practice of most physician's to work with the family and the patient in determining the appropriate care placement.
This response is not intended upon as legal advice and cannot be relied upon. You are urged to seek the services of an attorney licensed in your State should you wish to consider/take legal action.