Understanding nursing home discharge rules can help protect your loved one from being moved unsafely or without the proper process.
If you or a loved one is facing a nursing home discharge, it’s important to know this: you have rights. While some discharges are necessary or even welcomed, others may come unexpectedly or feel unfair. In many cases, they may even violate federal law.
What Is a Nursing Home Discharge?
A discharge or transfer occurs when a nursing home resident is asked to leave the facility, whether that means returning home, being transferred to a hospital, or being transferred to another nursing home. Some of these moves are voluntary, but many are not. Involuntary discharges are among the most common complaints in long-term care, and they can be deeply disruptive.
Verbal Discharges Are Not Allowed
No matter the reason, a resident cannot be discharged verbally. Facilities must provide a written discharge notice, and in most cases, they are required to give at least 30 days’ notice. Anything less—without a legitimate emergency—is against the law.
When Can a Nursing Home Legally Discharge a Resident?
Under federal law, there are only six legally valid reasons for discharging or transferring a resident:
- The facility can no longer meet the resident’s needs.
- The resident no longer needs nursing home care due to improved health.
- The resident poses a danger to others’ safety.
- The resident endangers the health of others.
- The resident has failed to pay after reasonable notice.
- The facility is closing.
Even if one of these conditions applies, the discharge must still follow proper procedures and timelines.
What Must a Nursing Home Do Before a Discharge?
Before a resident can be discharged or transferred, the facility is required to:
- Provide a written notice at least 30 days in advance
- Include in the notice:
- The reason for discharge
- The discharge location which must be a safe place that can meet a resident’s needs
- The effective date
- Information about appeal rights and how to file
- Assist in discharge planning, including referrals, medical records, follow-up care, and transportation.
The only exception to the 30-day rule is if the discharge must happen immediately due to an emergency involving health or safety.
Note that the ombudsman is required to be given a copy of each discharge notice.
Residents Facing Nursing Home Closures Have Different Rules
Closures are a different situation. When a nursing home closes, residents must be given at least 60 days’ notice. Recently, residents of the Silex Community Care Center in Lincoln County, Missouri, received such a notice. The planned August 31, 2025 closure will displace dozens of residents and workers—highlighting how important it is to understand the rules, get help early, and plan for safe transitions.
Red Flags That a Discharge Might Be Illegal
Watch out for signs that a nursing home is not following proper nursing home discharge rules:
- You’re told your loved one must leave “by tomorrow” without a written notice.
- The facility claims they can’t care for the resident but haven’t updated the care plan or offered support.
- Your loved one is being discharged for nonpayment but is applying for Medicaid or still within a payment window.
- You’re pressured to take your loved one home, even if their needs can’t be met safely.
In any of these cases, contact a Long-Term Care Ombudsman right away. You can also file an appeal, which halts the discharge process until a decision is made.
Know the Rules. Protect Your Loved One.
The bottom line: You don’t have to go through this alone. Nursing home residents have legal rights—and there are advocates who can help. VOYCE’s Long-Term Care Ombudsman Program serves 39 counties in Eastern Missouri, offering free support to residents and families facing discharge.
Whether you’re responding to a surprise discharge or planning for the future, understanding nursing home discharge rules gives you the power to protect your loved one and ensure they’re treated with dignity and care.