Discharged

Somebody has told you your mother is being discharged, and it has been said as though it were already settled. It is not.

Federal law lets a Medicare or Medicaid certified nursing facility transfer or discharge a resident for six reasons and no others:

1. her needs cannot be met there;
2. her health has improved so she no longer needs the services;
3. she endangers the safety of others;
4. she endangers the health of others;
5. she has failed to pay after reasonable notice;
6. the facility is closing.

That is 42 CFR 483.15(c)(1)(i), and it is a closed list. If what you were told is not on it, it is not a lawful basis.

And there is a second sentence almost nobody in the building will tell you. Under 42 CFR 483.15(c)(1)(ii) the facility "may not transfer or discharge the resident while the appeal is pending", unless it documents a danger to health or safety.

Appealing is not a complaint filed afterwards. It is what keeps her in the bed while somebody independent looks at it.

This book prints what the regulations actually say, with the citation attached, so you can put a provision number in an email:

• the thirty days of notice, and its five exceptions;
• everything the notice must contain, including your appeal rights and the ombudsman's phone number, which are legally required to be on it;
• the six reasons, one chapter each, and what each requires the facility to show;
• why the end of Medicare coverage is not a discharge reason, and why "she has plateaued" is not even the right test, because 42 CFR 409.32(c) says restoration potential "is not the deciding factor";
• the Medicare fast appeal, where the deadline is noon the next day;
• the right to come back after a hospital stay, even past the bed-hold, to the first available semi-private bed;
• and the free advocate in every state, the Long-Term Care Ombudsman, with a statutory right of "private and unimpeded access", access to her records, and standing to speak for her.

Every letter you need is written out to copy.

It is honest about the limits. Some discharges are lawful. Some appeals are lost. And the appeal deadline is set by your state rather than by any book, so this one deliberately prints no national date and tells you exactly where to get yours today.

United States. Information, not legal or medical advice. Current as of August 2026.