---
kind: "section"
citation: "38 C.F.R. § 51.80"
title: "38"
number: "51.80"
heading: "Admission, transfer and discharge rights."
url: "https://uscodex.org/cfr/38/51.80"
---

# §51.80. Admission, transfer and discharge rights.

- (a) **Transfer and discharge.**
  - (1) **Definition—** Transfer and discharge includes movement of a resident to a bed outside of the facility whether that bed is in the same physical plant or not. Transfer and discharge does not refer to movement of a resident to a bed within the same facility.
  - (2) **Transfer and discharge requirements.** The facility management must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless—
    - (i) The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the nursing home;
    - (ii) The transfer or discharge is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the nursing home;
    - (iii) The safety of individuals in the facility is endangered;
    - (iv) The health of individuals in the facility would otherwise be endangered;
    - (v) The resident has failed, after reasonable and appropriate notice to pay for a stay at the facility; or
    - (vi) **The nursing home ceases to operate.**
  - (3) **Documentation.** When the facility transfers or discharges a resident under any of the circumstances specified in [paragraphs (a)(2)(i) through (a)(2)(vi)](#a-2-i..a-2-vi) of this section, the primary physician must document this in the resident's clinical record.
  - (4) **Notice before transfer.** Before a facility transfers or discharges a resident, the facility must—
    - (i) 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.
    - (ii) Record the reasons in the resident's clinical record; and
    - (iii) **Include in the notice the items described in paragraph (a)(6) of this section.**
  - (5) **Timing of the notice.**
    - (i) The notice of transfer or discharge required under [paragraph (a)(4)](#a-4) of this section must be made by the facility at least 30 days before the resident is transferred or discharged, except when specified in [paragraph (a)(5)(ii)](#a-5-ii) of this section,
    - (ii) Notice may be made as soon as practicable before transfer or discharge when—
      - (A) The safety of individuals in the facility would be endangered;
      - (B) The health of individuals in the facility would be otherwise endangered;
      - (C) The resident's health improves sufficiently so the resident no longer needs the services provided by the nursing home;
      - (D) The resident's needs cannot be met in the nursing home;
  - (6) **Contents of the notice.** The written notice specified in [paragraph (a)(4)](#a-4) of this section must include the following:
    - (i) The reason for transfer or discharge;
    - (ii) The effective date of transfer or discharge;
    - (iii) The location to which the resident is transferred or discharged;
    - (iv) A statement that the resident has the right to appeal the action to the State official designated by the State; and
    - (v) **The name, address and telephone number of the State long term care ombudsman.**
  - (7) **Orientation for transfer or discharge.** A facility management must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility.
- (b) **Notice of bed-hold policy and readmission—**
  - (1) **Notice before transfer.** Before a facility transfers a resident to a hospital or allows a resident to go on therapeutic leave, the facility management must provide written information to the resident and a family member or legal representative that specifies—
    - (i) The duration of the facility's bed-hold policy, if any, during which the resident is permitted to return and resume residence in the facility; and
    - (ii) The facility's policies regarding bed-hold periods, which must be consistent with [paragraph (b)(3)](#b-3) of this section, permitting a resident to return.
  - (2) **Bed-hold notice upon transfer.** At the time of transfer of a resident for hospitalization or therapeutic leave, facility management must provide to the resident and a family member or legal representative written notice which specifies the duration of the bed-hold policy described in [paragraph (b)(1)](#b-1) of this section.
  - (3) **Permitting resident to return to facility.** A nursing facility must establish and follow a written policy under which a resident, whose hospitalization or therapeutic leave exceeds the bed-hold period is readmitted to the facility immediately upon the first availability of a bed in a semi-private room, if the resident requires the services provided by the facility.
- (c) **Equal access to quality care.** The facility management must establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services for all individuals regardless of source of payment.
- (d) **Admissions policy.** The facility management must not require a third party guarantee of payment to the facility as a condition of admission or expedited admission, or continued stay in the facility. However, the facility may require an individual who has legal access to a resident's income or resources available to pay for facility care to sign a contract to pay the facility from the resident's income or resources.

## Notes

### Amendments

[65 FR 968, Jan. 6, 2000, as amended at 74 FR 19434, Apr. 29, 2009]

### Authority

Authority: 38 U.S.C. 101, 501, 1710, 1720, 1741-1743, 1745, and as follows. Section 51.20 and 51.30 also issued under 38 U.S.C. 511, 1742, 7104 and 7105. Section 51.42 also issued under 38 U.S.C. 510, 1744, and Pub. L. 116-315 section 3007. Section 51.43 also issued under 38 U.S.C. 1712. Section 51.51 also issued under Pub. L. 116-315 section 3007. Section 51.310 also issued under 38 U.S.C. 1720(f).

### Source

Source: 65 FR 968, Jan. 6, 2000, unless otherwise noted.

### Amendments

[65 FR 968, Jan. 6, 2000, as amended at 74 FR 19434, Apr. 29, 2009]