Alaska

The grounds, as Alaska describes them

Not stated in the sources reviewed, for a facility-initiated transfer or discharge as such. The nursing-facility licensing article, 7 AAC 12.250 through 7 AAC 12.290 (Alaska Administrative Code, Alaska State Legislature), and the general rights section that applies to it, 7 AAC 12.890, enumerate no permissible bases for a facility to transfer or discharge a resident; the words transfer and discharge do not occur in the licensing article at all, and 7 AAC 12.890(a)(13) mentions a discharge plan only as a right "to participate in the development of a plan of care, or discharge plan," not as a ground.

What the sources state instead is a trigger for a Medicaid payment rule's own notice, not a list of grounds available to a facility. 7 AAC 140.545(a): "When a nursing facility's utilization review committee or the department determines that a recipient does not, or in the future will not, require continued nursing facility placement, the nursing facility shall provide, at least 10 days before the date of discharge, a written notice of proposed discharge" to the six parties the section lists. This is the only circumstance any source reviewed ties to a discharge, and it is a notice trigger inside a coverage rule, not an enumerated basis in the licensing article's own terms. The enumerated federal grounds for Medicare/Medicaid-certified facilities are assembled separately on the federal page; nothing here borrows from that page as if Alaska stated it.

The published process

Requesting the hearing

7 AAC 140.540(c): "A recipient who receives notice of a proposed transfer under (b) of this section may request a hearing under 7 AAC 49." 7 AAC 140.545(b) states the identical route for a proposed discharge. 7 AAC 49.030(a): "a request for a hearing within the scope of 7 AAC 49.020 must be made to the department in writing by a recipient, or by a legal representative acting on the recipient's behalf, not later than 30 days after the date of the notice required under 7 AAC 49.060. A hearing request may be accepted after the time limit under this section only if the administrative law judge finds, based on the evidence submitted, that the request for a hearing could not be filed within the time limit." Subsection (b): "Unless the request is denied under 7 AAC 49.080, the department will refer the matter to the office of administrative hearings (AS 44.64.010) as provided under AS 44.64.060 and 2 AAC 64.120."

The filing route itself is published on the department's own hearing-rights form, Uni-08 (Revised 2/1/2025): "You may submit your fair hearing request via:" a mailing address, "Attn: Fair Hearings" "P.O. Box 240808" "Anchorage, AK 99524"; a fax, "(907) 644-8126"; an email, "fairhearings@gainwelltechnologies.com"; or a telephone, "(907) 644-6800 or" "(800) 780-9972". The same form states: "You must submit your request within 30 days of the date on the enclosed letter under the authority of 7 AAC 49.030." It also states: "Per 42 CFR § 431.224 an expedited hearing may be requested if the time otherwise permitted for a hearing would jeopardize your life, health, or ability to attain, maintain, or regain maximum function."

The pendency provision, 7 AAC 49.190: a recipient "will, upon filing that hearing request, have the assistance reinstated retroactively or continued until the date that the final decision is issued, unless the recipient informs the department that the recipient does not want to receive continuing assistance." The Uni-08 form states the same continuation right in the department's own words: "If you are currently receiving benefits and you request a hearing, your benefits may be automatically continued while you wait for the hearing decision." It warns: "If you continue to receive benefits and the hearing authority determines the Department was correct to stop or reduce your benefits, you may be required to repay the cost of those services under the authority of 42 C.F.R. 431.230 (b), 7 AAC 49.190, and 7 AAC 49.200." 7 AAC 49.080: "Not later than 10 days after the department receives a hearing request, the department will either" deny it in writing with stated reasons or "grant the request and immediately refer the request for hearing to the office of administrative hearings for scheduling of a hearing or other appropriate proceeding." 7 AAC 49.180 states the outer limit on a decision: the administrative law judge's proposed decision must allow the commissioner "to issue a final decision as described in 7 AAC 150(c) not later than 90 days after the date on which the department received the request for a hearing."

The notice's required contents

7 AAC 140.540 and 7 AAC 140.545 state who must receive the transfer or discharge notice — the recipient, the recipient's family or guardian if applicable, the attending physician, and two divisions of the department — and the ten-day timing, but neither section states what the notice itself must contain. That absence is recorded here, not filled from the department's own general notice rule.

The general rule the department publishes for its own proposed actions, 7 AAC 49.070, is a different notice — from the department, of the department's own action to "deny, reduce, suspend, or terminate assistance" — and states what it must contain: "the department will state in the written notice the reasons for the proposed action, including the statute, regulation, or policy upon which that action is based." It further requires the department to inform the recipient "(1) of the recipient's right to a hearing; (2) how to request a hearing; (3) that if requested the department will assist the recipient in making a hearing request; (4) by whom the recipient may be represented or assisted; and (5) the conditions, if any, under which assistance may continue if a hearing is requested." 7 AAC 49.060 states when that department notice is due: "The department will give written notice to the recipient not later than 10 days before the date the department intends to take action denying, reducing, suspending, or terminating assistance, unless" one of eight stated circumstances applies, including where "a change in the level of medical care is prescribed by the recipient's physician" (subsection (6)).

Bed-hold and return

7 AAC 140.585(a): "Except as provided in (b) of this section, the department will pay for reserving a bed during a planned temporary absence of a recipient from a nursing facility if the absence is not more than 12 consecutive days and the time of departure and return of the recipient are recorded in the nursing facility's records." The section lists what counts: "a visit with relatives and friends" and "leave to participate in therapeutic or rehabilitative programs," including trial visits to alternative care settings, gradually increasing visit lengths to prepare for a return home, and an extended absence for workshop evaluation. Subsection (b): "The department will not pay for reserving a bed during a temporary absence of more than 12 consecutive days, unless the department gives prior authorization for the absence. The department will not pay for reserving a bed if the recipient has total absences in excess of 12 days during a 12-month period, unless the department gives prior authorization for the absence." Subsection (d) states the hospitalization rule separately and less favorably: "If a recipient leaves a nursing facility for hospitalization, the department will not pay to reserve the recipient's bed at the nursing facility."

No first-party statement of a resident's right to return to or resume residence in the facility after a bed-hold period — as distinct from whether Medicaid pays to reserve the bed — was found among the sources reviewed: the licensing article, the rights section, and this Medicaid coverage rule. That absence is recorded here rather than assumed from the payment rule.

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes and a resident's family almost never finds alone. They are quotations from Alaska's published sources, not a determination that any of them applies to any situation.

Notice periods and deadlines, as stated in the sources

All quoted; none calculated.

Ten days' notice before a transfer to another facility or hospital, and before a discharge — 7 AAC 140.540(b) and 7 AAC 140.545(a), each quoted in full in the docket and above.

Thirty days to request a hearing — 7 AAC 49.030(a), quoted in full above; the same 30 days is what the Uni-08 form states to the recipient directly.

Ten days for the department to act on a hearing request — 7 AAC 49.080, quoted in full above.

Ninety days from the hearing request to a final decision — 7 AAC 49.180, quoted in full above.

Ten days' notice before the department's own proposed action denying, reducing, suspending, or terminating assistance, unless a stated exception applies — 7 AAC 49.060, quoted in full above.

Twelve consecutive days, or twelve days total in twelve months, of Medicaid-reserved bed absence — 7 AAC 140.585(a)–(b), quoted in full above; no reservation is paid for a hospitalization absence at all, per subsection (d).

What any of these periods means for a particular case is for the office of administrative hearings or the relevant Alaska process to determine.

Source map

Captured: all eight, in tools/packets/alaska-packet.txt. Pending: any Alaska statute stating grounds or notice for a facility-initiated transfer or discharge from a nursing facility (none was located; the Legislature's statute site was not searched section by section — see finding 1); the Office of Administrative Hearings' own page on Department of Health cases; the Department of Health's Long Term Care provider billing manual, which may restate the notice sections.

Change log

2026-10-06 — Internet Archive captures recorded. Captures requested on 2026-09-06 by an automated capture pass and recorded this date; no human review is claimed for this entry. No quotation, date, finding or link above was changed by it. Each capture below was requested through Save Page Now and then confirmed to play back. Captures added: Division of Senior and Disabilities Services, Alaska Department of Health → https://web.archive.org/web/20260906125033/https://health.alaska.gov/en/resources/approved-sds-forms/; Alaska Department of Health → https://web.archive.org/web/20260906125109/https://health.alaska.gov/media/obljx4in/fair-hearing-rights-notice.pdf; Alaska State Legislature, Alaska Administrative Code (BASIS) → https://web.archive.org/web/20260906125156/https://www.akleg.gov/basis/aac.asp?media=print&secStart=7.12.250&secEnd=7.12.290; Alaska State Legislature, Alaska Administrative Code (BASIS) → https://web.archive.org/web/20260906125322/https://www.akleg.gov/basis/aac.asp?media=print&secStart=7.12.890&secEnd=7.12.890; Alaska State Legislature, Alaska Administrative Code (BASIS) → https://web.archive.org/web/20260906125606/https://www.akleg.gov/basis/aac.asp?media=print&secStart=7.140.540&secEnd=7.140.585; Alaska State Legislature, Alaska Administrative Code (BASIS) → https://web.archive.org/web/20260906125709/https://www.akleg.gov/basis/aac.asp?media=print&secStart=7.49.010&secEnd=7.49.200.

2026-09-27 — Deepened to a full page. Recaptured through the standing recipe (tools/recipes/alaska.json, recipe digest bd40de4590dd) before writing; the fresh capture (tools/packets/review/alaska-2026-09-27.txt) hashed identical to the capture already retained for 2026-09-17 and was retained as confirmed (tools/packets/history/alaska/manifest.jsonl), promoting to tools/packets/alaska-packet.txt with updated retrieval dates — no source text changed since the last confirmed pass. No new evidence was obtained: section 01 and section 02 are written entirely from the eight sources the baseline pass already captured. Findings (6) through (8), continuing the baseline's numbering: (6) 7 AAC 12.890(a)(13) is the only appearance of "discharge" in the rights section, and it names a discharge plan only as something a resident has the right to participate in developing, not a ground or a notice; quoted in section 01 to show precisely what the absence covers. (7) 7 AAC 140.540 and 7 AAC 140.545 state who must receive the transfer or discharge notice and its ten-day timing but not what the notice itself must contain; the department's own general notice-contents rule, 7 AAC 49.070, governs a different notice — the department's own proposed-action notice under 7 AAC 49.060 — and is quoted at that scope rather than presented as if it filled the gap in 140.540/140.545. (8) 7 AAC 140.585 states when Medicaid will pay to reserve a bed during a recipient's temporary absence (up to 12 consecutive days, none at all for a hospitalization under subsection (d)) but states no resident right to return to or resume residence in the facility as distinct from the payment question; that absence is recorded rather than inferred from the payment rule. Capture pending: per the source map, unchanged from the baseline pass. Internet Archive: not yet submitted for this pass. Reviewer: Carrie Schluter, reviewed 2026-09-27. Corrections: hello@fieldassembly.net.

2026-09-04 — Baseline page built from the first Alaska packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Alaska describes them, which on these sources would record the absence stated in the docket) and section 02 (the published process, including bed-hold and return, where 7 AAC 140.585 is captured and states that the department pays to reserve a bed during a planned absence of not more than 12 consecutive days and "will not pay to reserve the recipient's bed at the nursing facility" during hospitalization). Transports: the four Administrative Code sources were fetched by curl from the Legislature's BASIS application endpoint, aac.asp with media=print and a secStart/secEnd range, rather than from its pages, which render only to a scripted client; the request URL carries no session token, query hash or build identifier and is recorded in full in the packet and the recipe (tools/recipes/alaska.json), under the API rule in PROVENANCE.md. The endpoint returns a fragment with no body element, a single div.statute, which the recipe names as its scope. The form was read with pdftotext in layout mode; the three pages by tag-stripping the body. No browser or session-fetch transport was needed. Findings: (1) The licensing rule for nursing facilities, 7 AAC 12.250 – 12.290, and the rights section 7 AAC 12.890 state no grounds for a facility-initiated transfer or discharge, no notice period and no appeal route; the words transfer and discharge do not occur in the nursing-facility article. That is recorded as an absence in the grounds row. The Medicaid coverage rule is the only Alaska rule captured that states a period, and it states it for recipients. (2) 7 AAC 140.545(a) conditions its discharge notice on a determination "that a recipient does not, or in the future will not, require continued nursing facility placement"; it is a notice trigger, not a list of grounds, and is quoted as such. (3) The Legislature's print rendering carries no effective date, register number or history line for any section, so no source's own date can be stated for the four Code sources; the source map says so rather than supplying one from elsewhere. (4) The hearing route for a recipient runs through the department to the Office of Administrative Hearings; the one Alaska document that prints a filing address is the department's Uni-08 form, which routes mail, fax and email to the department's fiscal agent. The form's columnar layout renders address, fax, email and telephone across shared lines, and its contact facts are quoted as short spans rather than as one address block. (5) The Office of Long Term Care Ombudsman prints its street address and both telephone numbers on its home page and states its place in state government on its About Us page; the two pages agree. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-04. Corrections: hello@fieldassembly.net.