Arizona

The grounds, as Arizona describes them

R9-10-408(A)(1), the Department of Health Services' licensing rule for nursing care institutions: "A resident is transferred or discharged if:" "The nursing care institution is not authorized or not able to meet the needs of the resident, or" "The resident's behavior is a threat to the health or safety of the resident or other individuals" at the nursing care institution.

R9-10-408(B) adds a third basis, conditioned on notice rather than stated freestanding: "An administrator may transfer or discharge a resident for fail-" "ure to pay for residency if:" "The resident or resident's representative receives a 30-" "day written notice of transfer or discharge, and" "The 30-day written notice includes an explanation of the resident's right to appeal the transfer or discharge."

This is the only enumeration of grounds in the Arizona sources reviewed. AHCCCS's own appeal-of-discharge page, captured for section 02 below, separately quotes the federal standard at 42 CFR 483.15(c)(1) when describing who may use its appeal route; that is the federal floor as AHCCCS states it for its own purposes, not a second Arizona enumeration, and it is not folded into this section. Where AHCCCS's citation and R9-10-408 list different grounds, that is recorded as a finding in the change log rather than reconciled here.

The published process

Requesting the hearing

R9-10-408 requires a nonpayment notice to include "an explanation of the resident's right to appeal the transfer or discharge" (R9-10-408(B)(2)) and names no office, form, address, or deadline for that appeal, for a nonpayment case or any other.

The office that publishes a route is AHCCCS's Office of the General Counsel. Its Appeal of a Discharge Form states: "The following information is necessary to file an appeal of transfer or discharge from a registered nursing facility. Please attach discharge paperwork from the nursing facility when submitting this form to the Office of the General Counsel." and prints the office as "Office of the General Counsel" "Arizona Health Care Cost Containment System Administration (AHCCCS)" "150 N. 18th Ave., MD 15013" "Phoenix, AZ 85007" "Phone: 602-417-4232" "Email: NFdischarges@azahcccs.gov".

AHCCCS's general grievance-and-appeals page carries a dedicated subsection, "How a Nursing Facility Resident Can File an Appeal of a Transfer or Discharge" repeating the same office, address, phone, and email, and adding two things R9-10-408 does not state. First, the federal grounds it says a resident's appeal responds to: citing "42 CFR § 483.15(c)(3)" for the notice requirement and "483.15(c)(1)(i)" for the permitted grounds, the page states that "The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless -" the transfer or discharge is necessary for the resident's welfare and needs, the resident's health has improved enough that the facility's services are no longer needed, the safety or health of individuals in the facility is endangered, the resident has failed to pay after reasonable and appropriate notice, or the facility ceases to operate. This is AHCCCS's own statement of the federal standard, not a restatement of R9-10-408, and it lists more grounds than R9-10-408 does; the two are not reconciled here (see the change log). Second, and not stated anywhere in R9-10-408, a pendency rule: "The facility may not transfer or discharge the resident while the appeal is pending" "unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility. The facility must document the danger that failure to transfer or discharge would pose."

No captured Arizona source states a filing deadline for a nursing-facility transfer-or-discharge appeal specifically. AHCCCS's page states a ten-day continuation-of-services deadline elsewhere, for a health-plan or fee-for-service member's appeal of a reduced, suspended, or terminated service generally; that subsection does not mention discharges, and this page does not apply it to a nursing-facility transfer or discharge appeal. That absence is stated here rather than filled from the general rule.

The notice's required contents

R9-10-408(A)(2): documentation of a resident's transfer or discharge must include "The date of the transfer or discharge;" "The reason for the transfer or discharge;" and "A 30-day written notice except:" "In an emergency, or" "If the resident no longer requires nursing care institution services" as determined by a physician or the physician's designee. It must also include "A notation by a physician or the physician's desig-" "nee if the transfer or discharge is due to any of the reasons listed in subsection (A)(1)" and, where applicable, "actions taken by a personnel member to protect the resident or other individuals if the resi-" "dent's behavior is a threat to the health and safety of the resident or other individuals in the nursing care institution."

For a nonpayment transfer or discharge, R9-10-408(B) requires the same 30-day written notice, plus "an explanation of the resident's right to appeal the transfer or discharge." quoted above.

Separately, before a discharge (except in an emergency), R9-10-408(D)(1) requires the director of nursing to ensure written follow-up instructions are developed that include "Information necessary to meet the resident's need for medical services and nursing services" and "The state long-term care ombudsman's name, address, and telephone number;". A copy goes to the resident or representative, and a discharge summary is separately developed covering the resident's medical condition, medical and psychosocial history, the date, and the resident's post-discharge location (R9-10-408(D)(2)-(3)).

Bed-hold and return

R9-10-408, the licensing rule, states no bed-hold provision. Arizona's Medicaid bed-hold rule is R9-28-204(D)(3), in the Arizona Long-Term Care System (ALTCS) chapter of the Arizona Administrative Code: "Bed hold days as authorized by the Administration or its designee for a fee-for-service provider shall meet the fol-" "lowing criteria:"

"Short-term hospitalization leave for a member age 21 and over is limited to 12 days per AHCCCS ben-" "efit year, and is available if a member is admitted to a hospital for a short stay. After the short-term hos-" "pitalization, the member is returned to the institu-" "tional facility from which leave is taken, and to the same bed if the level of care required can be pro-" "vided in that bed" (R9-28-204(D)(3)(a)).

"Therapeutic leave for a member age 21 and older is limited to nine days per AHCCCS benefit year. A physician order is required for therapeutic leave from the facility for one or more overnight stays to enhance psycho-social interaction, or as a trial basis for discharge planning. After the therapeutic leave, the member is returned to the same bed within the institutional facility" (R9-28-204(D)(3)(b)).

"Therapeutic leave and short-term hospitalization leave are limited to any combination of 21 days per benefit year for a member under age 21" (R9-28-204(D)(3)(c)).

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Arizona'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.

Thirty days, general notice, with two exceptions — R9-10-408(A)(2)(c): documentation must include "A 30-day written notice except:" "In an emergency, or" "If the resident no longer requires nursing care institution services" as a physician or the physician's designee determines.

Thirty days, nonpayment notice — R9-10-408(B)(1): "The resident or resident's representative receives a 30-" "day written notice of transfer or discharge, and"

Pendency during an appeal — AHCCCS's grievance-and-appeals page, quoted in full in section 02 above: "The facility may not transfer or discharge the resident while the appeal is pending" "unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility."

Twelve days a year, short-term hospitalization bed-hold — R9-28-204(D)(3)(a), quoted in full in section 02 above.

Nine days a year, therapeutic-leave bed-hold — R9-28-204(D)(3)(b), quoted in full in section 02 above.

Twenty-one days a year, combined, for a member under 21 — R9-28-204(D)(3)(c), quoted in full in section 02 above.

What any of these periods means for a particular case is for the hearing office or the relevant state process to determine.

Source map

Captured: all five, in tools/packets/arizona-packet.txt. Pending: the Department of Health Services' own page for nursing care institutions, which links the Secretary of State's code rather than posting the rule; any first-party statement of a filing deadline for a nursing-facility transfer-or-discharge appeal specifically, distinct from the general ten-day continuation-of-services deadline AHCCCS states for other appeal types.

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: AHCCCS → https://web.archive.org/web/20260906130156/https://www.azahcccs.gov/Members/GetCovered/RightsAndResponsibilities/grievanceandappeals.html; AHCCCS, Office of the General Counsel → https://web.archive.org/web/20260906130309/https://www.azahcccs.gov/shared/Downloads/GrievanceAndAppeals/NFAppealOfADischargeForm.pdf.

2026-09-21 — Deepened to a full page: section 01 (the grounds, as Arizona describes them) and section 02 (the published process, including the notice's required contents in full, bed-hold and return, and the notice-periods register) are now written. Newly captured: R9-28-204, Institutional Services, in the Arizona Long-Term Care System (ALTCS) chapter of the Arizona Administrative Code (tools/recipes/arizona.json, extended with source 5; recipe digest 4bee96ede9a5, was ac7e57b789e8), whose (D)(3) is Arizona's Medicaid bed-hold rule; located after confirming the standing packet's own note that AMPM Policy 1240-A (direct care services) does not address bed-hold — it does not. Transport: apps.azsos.gov, already pinned to HTTP/1.1 for source 1, needed the same pin for this chapter; the section's own printed page spans two PDF pages (the chapter's running head falls between them), captured as pages 10-11, in pdftotext-raw mode for the same two-column reason already recorded for source 1 and confirmed against this span specifically. Findings, continuing the numbering from 2026-09-04: (5) AHCCCS's general grievance-and-appeals page, recaptured in full for this pass, carries a dedicated subsection — "How a Nursing Facility Resident Can File an Appeal of a Transfer or Discharge" — that the 2026-09-04 baseline did not quote from, deep in a long page. It states a pendency rule not found anywhere in R9-10-408: "The facility may not transfer or discharge the resident while the appeal is pending" "unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility." This corrects finding (2) of 2026-09-04, which read the sources as stating no stay of the move while an appeal is pending; the pendency statement was in the captured page then, and the earlier pass did not reach it. Whether it was added to the page between 2026-09-04 and this pass, or was always there and missed, was not determined; both captures are retained in tools/packets/history/arizona/. (6) That same subsection cites 42 CFR § 483.15(c)(1)(i) and quotes the federal standard's five grounds when describing who may use the appeal route. Those five grounds are not R9-10-408's own list of two (plus a third, conditioned, for nonpayment); this page keeps AHCCCS's citation in section 02, where it appears, and does not fold it into section 01's enumeration of Arizona's own grounds, per the federal/state separation this project holds throughout. (7) No captured source states a filing deadline for a nursing-facility transfer-or-discharge appeal specifically; AHCCCS's page states a ten-day continuation-of-services deadline for a health-plan or fee-for-service member's appeal of a reduced, suspended, or terminated service generally, in a subsection that does not mention discharges, and that deadline is not applied to this topic. Capture pending, continuing the 2026-09-04 list, now narrowed to: the Department of Health Services' own page for nursing care institutions, which links the Secretary of State's code rather than posting the rule. The AHCCCS discharge-appeal hearing description, pending as of 2026-09-04, is captured as of this entry (finding (5) above), though still without a stated deadline. Internet Archive: not yet submitted for the newly captured source. Reviewer: Carrie Schluter, reviewed 2026-09-21. Corrections: hello@fieldassembly.net.

2026-09-04 — Baseline page built from the first Arizona packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Arizona describes them) and section 02 (the published process, including the notice's required contents in full, bed-hold and return, and the notice-periods register). Transports: every source was fetched by curl with a browser user-agent through the capture recipe (tools/recipes/arizona.json); the two PDFs were read with pdftotext, the chapter file in raw mode because it is set in two columns and raw mode follows the column order, the form in layout mode; the two pages by tag-stripping the body. Two hosts, apps.azsos.gov and des.az.gov, refuse every HTTP/2 request curl makes (a 403 and a Cloudflare challenge page respectively) and serve the identical request over HTTP/1.1; the recipe pins those two sources to HTTP/1.1, an option added to the capture tool for this state, and that is the whole reason Arizona was recorded as unreachable on 2026-08-30. No browser or session-fetch transport was needed. Findings: (1) R9-10-408 states its grounds in two places and two registers — subsection (A)(1) states when a resident "is transferred or discharged", and subsection (B) states when an administrator "may" do so for nonpayment, with the 30-day notice and appeal explanation as conditions; both are quoted as published. (2) The rule requires a nonpayment notice to explain the right to appeal but names no office, form, address or deadline; the route that exists is published by AHCCCS, whose Appeal of a Discharge Form sends the appeal to its Office of the General Counsel. No Arizona source captured states a filing deadline for that appeal or a stay of the move while it is pending; that is recorded as an absence in the hearing row, with the general appeals page's ten-day continuation-of-services statement not applied to it, since that page does not mention discharges. (3) The Secretary of State's chapter file carries the current supplement date on every page and each section's amendment history in a Historical Note; the running head is the source's own date. (4) The Department of Economic Security prints the state ombudsman office's email behind Cloudflare's obfuscation script; the shared capture reader decodes it and the packet carries the address the department publishes. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-04. Corrections: hello@fieldassembly.net.