The states

One page per state, each quoting the state's own published materials on involuntary nursing-home transfer and discharge: the grounds, the notice, the office that hears the appeal, what the state publishes about bed-hold and return, and the long-term-care ombudsman's published contact. The federal floor — 42 CFR 483.15, the fair-hearing rules, and CMS guidance — is on a page of its own.

51 of 51 pages published. Muted abbreviations aren't published yet; the difference between jurisdictions is temporarily depth, never absence.

Published pages

Jurisdiction	Status, as the state's sources state it	Sources last checked
Alabama	Six grounds at Board of Health rule 420-5-10-.06(1)(b); notice at least 30 days, with five circumstances allowing notice as soon as practicable; the rule requires the notice to state a right to appeal to the State but names no office, address, form or deadline, and none is stated in the sources reviewed; the Department of Senior Services publishes one route to the ombudsman, 1-800-AGELINE	Sep 17, 2026
Alaska	The licensing rule for nursing facilities, 7 AAC 12.250 to 12.290, states no grounds, notice period or appeal route for a facility-initiated transfer or discharge, and the sources reviewed state no grounds; the Medicaid coverage rule, 7 AAC 140.540 and 140.545, requires a written notice at least 10 days before a recipient's transfer to another facility or hospital or discharge, with a hearing under 7 AAC 49 requested in writing to the department within 30 days and referred to the Office of Administrative Hearings; Medicaid pays to reserve a bed for a planned absence of up to 12 consecutive days, none for a hospitalization; the Office of Long Term Care Ombudsman is at 1-800-730-6393	Sep 27, 2026
Arizona	R9-10-408 of the Arizona Administrative Code states two grounds — the institution cannot meet the resident's needs, or the resident's behavior threatens health or safety — and a conditioned third for nonpayment; a 30-day written notice with two stated exceptions, which for nonpayment must explain the right to appeal; the rule names no office, and AHCCCS's Appeal of a Discharge Form and appeals page send the appeal to its Office of the General Counsel, 150 N. 18th Ave., Phoenix, stating the facility may not transfer or discharge while the appeal is pending absent a danger to health or safety, with no filing deadline stated; Medicaid bed-hold is 12 days a year for hospitalization and 9 for therapeutic leave under R9-28-204; the Long-Term Care Ombudsman Program is at (602) 542-6454 extension 9	Sep 21, 2026
Arkansas	Six grounds at 20 CAR § 400-2505(a)(1) of the Rules for Nursing Homes; a minimum of thirty days' written notice at § 400-2505(b) and a ten-day notification of transfer at § 400-411(7)(B), both in the same current Part and both quoted as published; the notice must state a seven-calendar-day right to appeal to the Secretary of the Department of Human Services, with a hearing scheduled within fourteen days, and the rule names no office, address or form; the ombudsman program's own site names its staff by region and prints no telephone number in its text	Sep 24, 2026
California	Grounds at 22 CCR 72527(a)(6); CDPH's All Facilities Letter AFL 25-17 states the notice, at least 30 days with four stated exceptions, and directs a facility's notice to cite a different, federal enumeration of the reason; the appeal goes to the Department of Health Care Services' Office of Administrative Hearings and Appeals, with no filing deadline or street address stated; 22 CCR 72520 and 51535.1 state a seven-day bed hold; the statewide Ombudsman Hotline is 1-800-231-4024	Sep 24, 2026
Colorado	Four grounds at 6 CCR 1011-1 Chapter 5, section 15.6(B); written notice at least 30 days, and five calendar days for a room change inside the facility; the appeal runs a four-step ladder printed on the face of the notice — staff designee, grievance committee, the Executive Director of the Department of Public Health and Environment, then an administrative hearing — and the ombudsman program is at 303.862.3524	Sep 24, 2026
Connecticut	Grounds at Conn. Gen. Stat. § 19a-535(b), with a medically contraindicated move barred outright; notice at least thirty and no more than sixty days; a written appeal to the Commissioner of Social Services within sixty days, or twenty to stay the move, filed through DSS's Office of Legal Counsel, Regulations and Administrative Hearings; § 19a-537 states bed-hold, reimbursement conditions, and a separate readmission-refusal hearing; the State Long-Term Care Ombudsman is at 1-866-388-1888	Sep 26, 2026
Delaware	16 Del. Admin. Code § 3102 states six grounds for certified facilities at § 3.1, and a differently worded five-item list for other nursing facilities at § 4.2, both quoted as published; notice at least 30 days with four stated as-soon-as-practicable exceptions; a fair-hearing request goes to the facility itself within 30 days, copied to the Division and the state ombudsman, and the regulation names no separate hearing office, filing address or form; the Long-Term Care Ombudsman Program is at 1-855-773-1002	Sep 26, 2026
District of Columbia	Five grounds at D.C. Code § 44-1003.01(a), for discharge, transfer to another facility or relocation within the facility; notice at least 21 calendar days before a discharge or transfer and 7 before a relocation under § 44-1003.02(a), with two stated exceptions, while DC Health's prescribed notice form states thirty days, both shown as published; a written hearing request within 7 calendar days (5 for a relocation) stays the move and is heard at the Office of Administrative Hearings, 441 4th Street NW; 29 DCMR § 950 caps Medicaid reimbursement for a reserved bed at eighteen days a fiscal year; the Office of the D.C. Long-Term Care Ombudsman is at 202-434-2190	Sep 27, 2026
Florida	Grounds at section 400.022(1)(p), Florida Statutes — medical reasons, the welfare of other residents, or nonpayment; notice at least 30 days under section 400.0255(7); the Department of Children and Families' Office of Appeal Hearings conducts the hearing, on a request within 90 days or within 10 to stay the move, and two agencies publish different addresses for that office, both shown as published; AHCA's Medicaid coverage policy states an 8-day bed hold for a hospital stay, a different number from the licensure statute's own 15 days; the ombudsman program is at 1-888-831-0404	Sep 27, 2026
Georgia	Four bases at Rule 111-8-50-.11(2), the emergency case stated separately; written notice at least 30 days, and 15 days for a move within the same facility; an informal grievance step may precede the administrative hearing before the Department of Community Health, filed at ltc.discharge@dch.ga.gov (no postal address or form published); Medicaid holds a bed up to 7 days for a hospitalization; the state ombudsman is reached at 1-866-552-4464	Sep 27, 2026
Hawaii	Hawaii states its nursing facility rules in HAR Chapter 11-94.2, adopted September 16, 2022, which the Department of Health publishes only as a scanned image with no text layer; the chapter's grounds and notice provisions are therefore present but unquoted on this page, which links the file; no captured source names the office that hears a resident's appeal of a facility-initiated transfer or discharge, and the Med-QUEST appeals page addresses eligibility and health-plan actions only; the Long-Term Care Ombudsman Program is at 586-7268 (Oahu)	Sep 29, 2026
Idaho	The 2025 Legislature voided the state's licensing rule, IDAPA 16.03.02, and its replacement, the Streamlined Facilities Licensing and Inspection Act, states no grounds, notice, or hearing route for a transfer or discharge; a Medicaid rule pays to reserve a bed only for a therapeutic home visit, not a hospital stay; the Long-Term Care Ombudsman Program is at the Idaho Commission on Aging, (208) 334-3833	Sep 29, 2026
Illinois	Four reasons at section 3-401 of the Nursing Home Care Act; a minimum written notice of 30 days on a department form carrying a hearing request form and a postage-paid envelope; the request goes to the Department of Public Health's Division of Administrative Hearing Review within 10 days and stays the move; the Department on Aging's Senior HelpLine is 1-800-252-8966	Sep 29, 2026
Indiana	Six grounds at 410 IAC 16.2-3.1-12(a)(4), printed as checkboxes on the prescribed notice; notice at least 30 days with five stated exceptions; a written hearing request goes to the Indiana Department of Health postmarked within 10 days of the notice; Indiana Medicaid does not pay to hold a nursing-facility bed outside hospice care; and the Office of the Long Term Care Ombudsman is at 800-622-4484	Sep 29, 2026
Iowa	Six reasons at 481 IAC 58.40(1), and no move solely because care is paid under chapter 249A; notice at least 30 days, or within 48 hours after an emergency move; the rule prints the appeal statement on the notice itself — a request to the Department of Inspections and Appeals within 7 days, heard within 14, with no transfer before a final decision — and the ombudsman is at 866-236-1430	Sep 29, 2026
Kansas	No grounds are stated in the sources reviewed: K.S.A. 39-936(g) states a 30-day notice and no bases, and K.A.R. 28-39-147 and 28-39-148 are printed in the Secretary of State's volume as revoked on May 22, 2009; no captured source names an office, address, form or deadline for an appeal; the Office of the Long-Term Care Ombudsman is at 1-877-662-8362	Oct 6, 2026
Kentucky	Six grounds at 900 KAR 2:050, Section 2(1), reaching relocations inside the building; notice at least 30 days; the resident informs the Cabinet for Health and Family Services in writing within 15 days, with no office, address, email or form for that filing stated in the sources reviewed; the Cabinet publishes the ombudsman by county rather than a statewide number	Oct 1, 2026
Louisiana	Five circumstances at LAC 48:I.9775.B; notice at least 30 days, shortened to fifteen for nonpayment in a facility not certified under Title XVIII or XIX; the appeal goes to the Division of Administrative Law, whose published general Medicaid fair-hearing route (address, fax, and a filing window typically 30 days) is not stated to govern this appeal specifically; Medicaid reimburses up to 7 hospital and 15 home leave days a year; the Louisiana Ombudsman Program's state office is at (866) 632-0922	Sep 15, 2026
Maine	Five circumstances at 10-144 CMR chapter 110, 10.Q.2, restated as a differently worded six-item list in the MaineCare Benefits Manual's own resident-rights section; notice at least 30 days with stated exceptions; the MaineCare Benefits Manual sends a written hearing request to the Office of Administrative Hearings, heard on an expedited basis with a written decision in three working days, and a resident who requests a hearing within ten days of the notice is not moved before the decision; the department's own general fair-hearing FAQ separately states a 30-day appeal window; the Maine Long-Term Care Ombudsman Program, a designated nonprofit, is at 1-800-499-0229 or 207-621-1079	Oct 8, 2026
Maryland	Five reasons at Health-General § 19-345(a), the regulation adding decertification or withdrawal from Medicare or Medicaid; notice at least 30 days, or 60 where the facility is part of a continuing care retirement community; a written hearing request goes to the Office of Administrative Hearings by the 30th calendar day, with no address, form or telephone number for it stated in the sources reviewed; no statewide ombudsman telephone number is published on the page reviewed	Oct 3, 2026
Massachusetts	Six circumstances at 130 CMR 456.701(A), with a failure to readmit after a medical leave deemed a transfer or discharge; notice at least 30 days, hand delivered in 12-point or larger type; appeals go to MassHealth's Board of Hearings within 30 days, or 14 for an emergency move, and the Commonwealth publishes two different mailing addresses for that office, both shown as published; the Long-Term Care Ombudsman is at 617-222-7495	Oct 3, 2026
Michigan	Four purposes at MCL 333.21773(1), carried on the department's notice form beside the federal list; written notice at least 30 days with three stated exceptions, on a prescribed form with a hearing request form and a postage-paid envelope; the appeal must reach the Department of Licensing and Regulatory Affairs within 10 days and stays the move, though the hearing itself is held by a separate office (MOAHR); Medicaid bulletins set a 10-day hospital-leave hold and an 18-day therapeutic-leave allowance; the Michigan Long Term Care Ombudsman is at 1-866-485-9393	Oct 4, 2026
Minnesota	No enumeration of grounds appears in either captured statute, or in Minnesota Rules chapter 4658 — § 144.651, subdivision 29 states a standard, that residents shall not be arbitrarily transferred or discharged; written notice no later than 30 days before discharge and seven before a move to another room; a written hearing request goes to the commissioner of health within 30 days, filed through the Department of Health's own online appeals form, and a timely appeal holds the move; the Office of Ombudsman for Long-Term Care is at 1-800-657-3591	Oct 4, 2026
Mississippi	Grounds stated as a resident right in licensure standard Rule 45.17.2(4) rather than enumerated; two publishers state two periods, a two-week advance notice in the licensure standard and thirty calendar days in the Division of Medicaid's Rule 2.20, both quoted as published; Title 23 Part 300's Rule 2.3.A.4 names nursing-facility transfer and discharge as an appeal category and routes a request through a regional or central office to the Office of Administrative Appeals within 30 days, though neither rule cites the other; bed-hold is up to 15 consecutive days under Rule 2.8; the statewide ombudsman help line is 1-888-844-0041	Oct 4, 2026
Missouri	Six lettered circumstances at 19 CSR 30-82.050(2); notice no less than 30 days, with an emergency discharge as soon as practicable; the appeal is filed with the Department of Health and Senior Services Appeals Unit within 30 days of receipt, by letter, fax or email with no form required, and filing stays the discharge unless the facility shows good cause; the state ombudsman office is at 800-309-3282	Oct 6, 2026
Montana	Montana's own licensing rule for skilled nursing and skilled/intermediate care facilities states no grounds or notice of its own, adopting the federal Conditions of Participation, 42 CFR part 483, by reference instead; a separate statute, MCA 50-5-1104, states a 21-day advance-notice right for involuntary transfer or discharge, while the state ombudsman program's own page states 30 days, both quoted as published; a hearing request for a nursing facility resident's transfer or discharge goes to the Office of Fair Hearings within 30 days; the Long-Term Care Ombudsman help line is at (800) 332-2272	Oct 6, 2026
Nebraska	Five bases at Neb. Rev. Stat. § 71-6022(1); three notice periods keyed to the ground — thirty days ordinarily, five where rehabilitation allows a less restrictive setting, ten for nonpayment five days or more in arrears; the licensure statute states no appeal route, but 471 NAC 12-007.21 (Medicaid) directs a discharge or transfer appeal to DHHS under the department's general fair-hearing chapter (465 NAC 2 and 6); bed-hold is funded up to 15 hospital days and 18 therapeutic-leave days a year; the ombudsman is at (800) 942-7830	Oct 6, 2026
Nevada	Five circumstances at NAC 449.74429(1); notice at least 30 days from two publishers, with NRS 449A.114(1)(b) adding a right to meet the administrator within ten days; the licensing rule requires the notice to state a right of appeal but names no office, and the office is named instead in the Medicaid Services Manual — a Fair Hearing request to the Division of Health Care Financing and Policy within 90 calendar days of the notice date; the ombudsman helpline is 1-888-282-1155	Oct 6, 2026
New Hampshire	Reasons at RSA 151:21, V, with no involuntary discharge because the patient becomes eligible for medicaid; written notice at least 30 days, with four circumstances allowing notice as soon as practicable; the notice must state a right to appeal in superior or probate court, and a petition there stays the move, while a resident of a certified facility must also be told of a right to an administrative hearing before the department of health and human services that no captured source ties to a named office, form or deadline; the ombudsman is at (603) 271-4375	Oct 6, 2026
New Jersey	Grounds stated by the Office of the Long-Term Care Ombudsman as a resident right, and set out for facilities as a six-item list keyed to the federal regulation; notice at least 30 days, or 60 where the facility is closing; appeals go to the Fair Hearing Unit of the Division of Medical Assistance and Health Services, whose address the ombudsman office publishes and whose deadline is not stated in the sources reviewed; the ombudsman is at 1-877-582-6995	Oct 8, 2026
New Mexico	Eight circumstances at 8.370.16.38(A)(2) NMAC, with the same current rule's resident-rights section stating a narrower three; written notice at least 30 days, with a planning conference at least three days before an involuntary removal; the licensing rule names no hearing office of its own, and the Health Care Authority's Office of Fair Hearings takes a nursing-facility discharge appeal within 90 days; the licensing rule leaves bed-hold duration to each facility's own policy while the Medicaid rule separately covers six reserve bed days a year for hospitalization; the Long-Term Care Ombudsman Program is at 1-866-451-2901	Oct 8, 2026
New York	10 NYCRR 415.3 states the grounds and a 30-day notice with six stated exceptions; the appeal is heard by the Department of Health itself, filed within sixty days of receipt, through the Nursing Home Complaint and Discharge Appeal Hotline at 1-888-201-4563 or the department's online form, with a 15-day window under the regulation to remain in the facility pending the hearing; 18 NYCRR 505.9 states a 15-day Medicaid bed reservation, extendable to 20; the State Long Term Care Ombudsman is at 1 (855) 582-6769	Oct 8, 2026
North Carolina	Grounds at N.C.G.S. § 131E-117(15), with NC Medicaid's prescribed notice stating a different six-item list under the federal regulation, both shown as published; five days' advance notice, and no 30-day period appears in the captured sources; the appeal goes to the NC Medicaid Hearing Office within 11 calendar days of the notice; Medicaid has no bed-hold provision for a hospital stay but allows 60 days of therapeutic leave a year; the ombudsman program runs through sixteen regional offices and publishes no statewide telephone number on the page reviewed	Oct 10, 2026
North Dakota	Ten grounds at NDAC 75-01-03-08.1(7); notice at least 30 days with five stated as-soon-as-practicable exceptions; a resident may request a fair hearing before the department when a facility has erroneously determined a transfer or discharge, and the department publishes two different names and addresses for the same Appeals Supervisor office; bed-hold sits in a separate ratesetting chapter and the department's own Medicaid billing manual, which states a different number of covered therapeutic leave days than the rule does; the Long-Term Care Ombudsman Program is at (701) 328-4617 or toll-free 1-855-462-5465	Sep 25, 2026
Ohio	Eight enumerated grounds at ORC 3721.13(A)(30); notice at least thirty days in advance with stated exceptions; the written hearing request goes to the Department of Health, bed-hold sits in the Department of Medicaid's rule, and the ombudsman with the Department of Aging	Oct 10, 2026
Oklahoma	Three reasons at 63 O.S. § 1-1926, with conditions attached in the department's rule; the statute states a minimum written notice of ten days and the rule thirty, both quoted as published; a written hearing request goes to the Hearing Clerk at the Oklahoma State Department of Health within 10 days, the hearing convenes within ten working days, and the discharge is stayed while it is pending; the ombudsman program is at (405) 521-6734 or 1-800-211-2116	Oct 11, 2026
Oregon	Grounds grouped by OAR 411-088-0020 into medical and welfare reasons, non-payment reasons and others; five notice periods keyed to the ground, from none in a medical emergency to 60 days for a voluntary closure; the resident is entitled to an informal conference and then a contested-case hearing, requested within 10 business days by rule or 10 calendar days by the department's standard form (which also supplies a P.O. Box address the rule itself does not), and the move is frozen once a request is made; bed-hold turns on whether payment for the hospital stay is offered, and readmission is a right for 180 days; the Office of the Long-Term Care Ombudsman is at (800) 522-2602	Oct 11, 2026
Pennsylvania	No Pennsylvania regulation enumerating the bases was captured; what the Commonwealth publishes sits in the Department of Human Services' Long-Term Care Handbook at section 423.61; 30 days' advance written notice, not required for an emergency or an urgent need for medical services the facility cannot provide; the appeal is filed with the Bureau of Hearings and Appeals through the county assistance office within 30 days, on no particular form; the ombudsman program is at 717-783-8975	Oct 11, 2026
Rhode Island	Six conditions at 210-RICR-50-00-7, with the statute and the licensing rule stating the same event more narrowly; a uniform 30 days' advance notice, with five circumstances allowing as many days as practicable; the appeal goes to the Executive Office of Health and Human Services Hearing Office within thirty days, and filing within ten keeps the resident in place; the state ombudsman is at 401.785.3340 or 1.888.351.0808	Sep 23, 2026
South Carolina	Four grounds and the notice period in one sentence at S.C. Code § 44-81-40(D) — medical reasons, the resident's or other residents' welfare, or nonpayment — with not less than thirty days' written notice, shortened to what is practicable where other residents' safety is endangered; a nursing-home discharge or transfer notice is one of the stated occasions for a Medicaid fair hearing before SCDHHS's Office of Appeals and Hearings, filed online, by mail, fax or email, though the department's own materials leave the filing deadline to the individual notice rather than stating one; the Long Term Care Ombudsman is at 1-800-868-9095	Oct 13, 2026
South Dakota	Five grounds at ARSD 44:73:11:14(1); notice at least 30 days, with exceptions for a change in the resident's health, an immediate transfer or discharge, or residency under 30 days; the rule requires only that the facility's own policy describe how to appeal, naming no office, address, form or deadline, and no first-party document found ties a facility's transfer-or-discharge decision to the Department of Social Services' Office of Administrative Hearings; the Long-Term Care Ombudsman Program is at 833-663-9673	Oct 13, 2026
Tennessee	Six grounds stated in the second person on TennCare's prescribed notice, four of them conditioned on a doctor's agreement; 30 days from the notice unless a documented exception applies, and no involuntary move until the department and the area ombudsman have been informed; the appeal goes to TennCare's Commissioner's Designee at 1-833-582-1224, and an appeal within 30 days usually holds the move; Medicaid bed-hold days were eliminated effective July 1, 2018; the State Long-Term Care Ombudsman is at 1-877-236-0013	Sep 15, 2026
Texas	HHSC publishes nearly all of it: seven bulleted grounds in Provider Letter PL 2022-25, written notification at least 30 days before the intended discharge date, a fair hearing requested through HHSC within 90 days, and the LTC Ombudsman Program at 1-800-252-2412	Oct 8, 2026
Utah	R432-150 states five grounds for transfer or discharge and a 30-day notice with stated exceptions, but the licensing rule itself names no hearing office; the Division of Aging and Adult Services' own discharge-appeal form routes a resident's 30-day appeal to the Office of Administrative Hearings instead, and two department pages give that office a different zip code than the appeal form and the Provider Manual do. Utah's Medicaid hearing rule, R410-14, separately states that services continue if a hearing is requested within ten days of a mailed notice. The State Long-Term Care Ombudsman is at 385-222-1273	Sep 24, 2026
Vermont	Six grounds at rule 3.14 b. of the Licensing and Operating Rules for Nursing Homes, and a differently worded three-part statement at 33 V.S.A. § 7301(2)(D), both quoted as published; notice at least 30 days before a discharge and 72 hours before a transfer within the facility, with stated emergency exceptions; an oral or written appeal within 10 business days to the facility's administrator or to the director of the Division of Licensing and Protection, decided within eight business days, then a written request within 10 business days to the Human Services Board, which hears it de novo; the Vermont Long-Term Care Ombudsman Project, operated by Vermont Legal Aid, is at 1-800-889-2047 ext. 3	Sep 26, 2026
Virginia	Four circumstances at Code of Virginia § 32.1-138.1(A), reaching transfers within the facility; reasonable advance written notice at least five days before the move, with prior consultation required except in an emergency, though DMAS's own manual separately restates a thirty-day standard; the DMAS Appeals Division hears nursing facility discharge appeals, and its published general Medicaid filing deadline (30 days) is not stated to apply to this appeal specifically; no statewide ombudsman telephone number is published on the page reviewed	Sep 25, 2026
Washington	Four grounds at RCW 74.42.450(3) and six at WAC 388-97-0120(1), with reasonable accommodations to be attempted first; notice 30 days in advance of a facility-initiated move and 15 in advance of one initiated by the nursing home, as the rule states each; a forum is stated only for a department discharge decision, at DSHS's general Office of Administrative Hearings, which neither nursing-facility rule cites by number; no captured source names an office, deadline or address for appealing a facility-initiated move; Medicaid pays up to 18 days a year of social/therapeutic bed-hold, no hospitalization-specific number stated; the Long-Term Care Ombudsman Program is at 1-800-562-6028	Sep 21, 2026
West Virginia	Five circumstances at 64 CSR 13, section 4.13.b, with a discharge to a community setting against the resident's will barred outright; notice at least thirty days, with five stated exceptions; the notice must state a right to appeal to the State Board of Review, and only the Medicaid provider manual states the appeal is a stay ("may choose to stay in the facility") and a Medicaid bed-hold of up to 18 days a year; neither source states an address, form or deadline for the Board; the Long-Term Care Ombudsman Program is at 1-800-834-0598	Sep 22, 2026
Wisconsin	Ten circumstances at DHS 132.53(2)(a), more than any other state in this index, with an alternative placement required first except for nonpayment or a medical emergency; at least 30 days' notice and a planning conference at least 14 days before the move; the appeal runs two stages — a letter to the nearest regional office of the department's bureau of quality assurance within 7 days, which holds the move, then the Division of Hearings and Appeals within 5 days of that decision; the Board on Aging and Long Term Care is at 1-800-815-0015	Sep 18, 2026
Wyoming	Neither of the Department of Health's nursing care facility rules, Chapter 11 and Chapter 19, nor the Health Facilities Act states a ground, notice period or resident appeal for a facility-initiated transfer or discharge, and the sources reviewed state none; the only resident-side hearing published is the Medicaid administrative hearing of Chapter 4, reached from a level-of-care determination under Chapter 22, requested from the Department within twenty business days; Wyoming Medicaid does not cover a reserved bed beyond 24 hours and a provider may bill the resident directly for the rest; the State Long-Term Care Ombudsman is at 307-287-7757	Sep 27, 2026