Empowering families to advocate for quality nursing home care

Resident's Rights

Admission, Transfer and Discharge Rights


Transfers and discharges are common occurrences in many nursing homes.  A transfer and discharge includes movement of a resident to a bed outside of the nursing home.  Transfer and discharge does not apply to the relocation of a resident to a different bed within the same nursing home.

Transfer and discharge requirements

  • The facility must permit each resident to remain in the facility
  • The facility can only transfer or discharge a resident for the following reasons:
    • The resident’s needs cannot be met in the facility
    • The resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility
    • The safety of individuals in the facility is endangered
    • The health of individuals in the facility would otherwise be endangered
    • Nonpayment
    • The facility ceases to operate

Documentation required by the facility before a transfer or discharge is initiated

  • A resident’s physician must document the necessity of a transfer or discharge within the resident’s medical record
  • A physician may order a transfer or discharge if the safety of other individuals is endangered

Notice before transfer
Before a facility transfers or discharges a resident, the facility must:

  • Notify the resident and, if known, a family member or legal representative of the resident of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand
  • Record the reasons in the resident’s clinical record
  • Include in the notice the specified reason(s) for transfer or discharge

Timing of the notice

  • The facility must provide notice at least 30 days before the resident is transferred or discharged except in those cases when a resident is a danger to self or others or the facility ceases to operate
  • The facility may provide notice as soon as practicable before a transfer or discharge when:
    • A resident is a danger to self or others
    • A resident’s health improves to allow an immediate transfer or discharge
    • A resident requires urgent medical attention
    • A resident has not resided in the facility for 30 days

Contents of the notice

The written notice must include:

  • The reason for transfer or discharge
  • The effective date of transfer or discharge
  • The location to which the resident is transferred or discharged
  • A statement that the resident has the right to appeal the action to the State
  • The name, address and telephone number of the State Long-Term Care Ombudsman
  • For nursing facility residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled
  • For nursing facility residents who are mentally ill, the mailing address and telephone number of the agency responsible for the protection and advocacy of mentally ill

Orientation for transfer or discharge

  • A facility must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility.

Notice in advance of facility closure 

  • In the case of facility closure, the administrator of the facility must provide written notification prior to the impending closure to:
    • The Secretary
    • The State Long-Term Care Ombudsman
    • Residents or legal representatives, as well as the plan for the transfer and adequate relocation