Colorado

The grounds, as Colorado describes them

6 CCR 1011-1 Chapter 5, section 15.6(B), Resident transfer, discharge or room change — Colorado Secretary of State, Code of Colorado Regulations (generated PDF), adopted by the Board of Health on April 16, 2025, effective July 1, 2025, retrieved 2026-08-30 — states: "A resident shall not be transferred or discharged unless:", in the rule's own order:

"The transfer or discharge is necessary for the resident's welfare." — with a further condition for certified facilities: "Facilities that are certified to participate in the Medicaid and/or Medicare reimbursement program must also demonstrate that the resident's needs cannot be met in the facility,"

"The transfer or discharge is only for medical reasons." — carrying the same certified-facility condition, in the rule's own repeated wording: "Facilities that are certified to participate in the Medicaid and/or Medicare reimbursement program must also demonstrate that the resident's needs cannot be met in the facility,"

"The transfer or discharge is necessary to preserve the welfare of other residents, or"

"The resident has failed to pay for (or to have paid under Medicaid or Medicare) a stay at the facility." — with its own notice condition for certified facilities: "Facilities that are certified to participate in the Medicaid and/or Medicare reimbursement program must also provide the resident with reasonable and appropriate notice regarding non-payment and its consequences at least 30 calendar days before initiating a transfer or discharge" for non-payment.

For the first three grounds, section 15.6(D) adds a procedural condition: "the facility shall provide assessment and reasonable intervention prior to determining the need for the transfer or discharge. The assessment, attempted intervention and reason for the discharge or transfer shall be documented in the resident's health information record." Section 15.1(L), the chapter's statement of residents' rights, states a further right that bears on the grounds without adding one: "The right not to be transferred or discharged for raising concerns or complaints."

The published process

Requesting the hearing

Section 15.6(F)(5) requires the written notice to carry this text, blanks included, verbatim:

"You have a right to appeal the nursing care facility's decision to transfer or discharge you. If you think you should not be transferred or discharged, you must appeal to _________ (staff designee) within 14 calendar days. If you do not wish to handle the appeal yourself, you may use an attorney, relative, or friend. If your appeal is not resolved to your satisfaction by the staff designee, you may appeal to the nursing care facility's grievance committee within 10 calendar days of receipt of the decision of the staff designee. If your appeal is not resolved to your satisfaction by the nursing care facility's grievance committee, you may appeal to the Executive Director of the Colorado Department of Public Health and Environment within 10 calendar days of receipt of the grievance committee decision. If you are not satisfied with the Executive Director's decision, you have 30 calendar days to request that the Department of Public Health and Environment set the matter for an administrative hearing. You may direct questions regarding this notice to the Department of Public Health and Environment at____________________(division name, address and phone number)."

The pendency statement is section 15.6(J): "A resident shall not be involuntarily transferred, discharged, or moved to another room within the facility until:" "The expiration of the facility notice period, and" "The time for filing a grievance or appeal has expired, or" "The grievance or appeal has been resolved." No street address, form, or portal for any of the four steps is stated in the rule itself; the rule leaves the staff designee's name and "division name, address and phone number" as blanks the facility fills in, and no other first-party page naming the Department of Public Health and Environment's own filing address for this specific appeal was found. Not stated in the sources reviewed.

The notice's required contents

Section 15.6(F): "The written notice shall be in a language and manner understandable to the resident and the resident representative, if applicable, and shall include:" "The reason for the transfer or discharge," "The effective date of the transfer or discharge," "The location to which the resident is transferred or discharged," "The grievance procedure, and" the appeal-rights text quoted in full above. For a certified facility, 15.6(F)(5)(a) requires a further statement: "In addition, if you have questions or complaints about the transfer or discharge or would like help to appeal, call or write the state or local Long-Term Care Ombudsman at ___________(phone numbers/addresses)." Two further statements are required in narrower circumstances: for a resident with a developmental disability, 15.6(F)(5)(b), and for a resident with mental illness, 15.6(F)(5)(c), each naming the advocacy agency responsible for that resident by blank. Section 15.6(G) adds a routing requirement for a certified facility: a copy of the written notice, "including the grievance and appeal rights, and current contact information for the state and local Long-Term Care Ombudsman", must "also be sent to the state and local Long-Term Care Ombudsman at the same time it is sent to the resident or as soon as the determination is made that the transfer or discharge is involuntary."

Bed-hold and return

Two publishers, two layers. The health department's licensing rule states a policy requirement with no day count: 6 CCR 1011-1 Chapter 5, section 5.2 — "The facility shall develop policies for holding beds available for residents who are temporarily absent from the facility, provide a copy of the policy upon admission and explain these policies to residents upon admission and before each temporary absence."

The Medicaid payment rule, 10 CCR 2505-10 8.400, sections 8.482.42 through 8.482.44 (Medical Services Board, Department of Health Care Policy and Financing, Colorado Secretary of State, Code of Colorado Regulations (generated PDF), current version effective 08/14/2026, retrieved 2026-09-19), states the day counts and the reservation itself. For a hospital stay, "Medical Leave" is defined at 8.482.43(A): "absence of the resident from the nursing facility due to admission to a hospital or other institution", conditioned on the absence being "on the orders of a physician" and that "The resident plans to return to the nursing facility;" For any other leave, 8.482.44: "Medicaid will pay a nursing facility to hold a bed for non-medical and/or programmatic leave days up to a combined total of 42 days per resident per calendar year." Both kinds of leave carry the same reservation term, stated twice in the rule, once for each: "The specific bed which the resident had occupied prior to leave must be reserved. No other resident may occupy the reserved bed." (8.482.43(C)(2) and, in the same words, 8.482.44(E)). For medical leave, the room-reservation charge is capped: "The per diem charge for room reservations for Medical Leave cannot exceed the per diem rate currently authorized for the nursing facility, less total food and linen service costs. In no case shall the charge be greater than the current per diem rate less $2." And where the resident has no other source of payment: "If no source of payment, other than the resident's funds, are available, and the nursing facility's current occupancy is less than 90 percent of capacity, the room must be reserved at no charge to the resident."

No provision beyond the bed reservation itself — no separate readmission or priority-of-return statement — is stated in either rule. Not stated in the sources reviewed.

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Colorado'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' advance notice — section 15.6(E): "Reasonable advance notice means notice in writing at least 30 days before the transfer or discharge except in the following circumstances in which the professional staff determines there is an emergency, in which case the notice must be made as soon as practicable before the transfer or discharge:" the endangerment and urgent-medical-needs circumstances quoted in the docket above.

Thirty calendar days before a non-payment transfer — section 15.6(B)(4)(a): certified facilities "must also provide the resident with reasonable and appropriate notice regarding non-payment and its consequences at least 30 calendar days before initiating a transfer or discharge" for non-payment.

Five calendar days for a room change — section 15.6(I): written notice of an involuntary room change "to be received at least five calendar days before such move, including an explanation of their right to appeal."

Fourteen calendar days to appeal to the staff designee, ten calendar days to the grievance committee, ten calendar days to the Executive Director, and thirty calendar days to request an administrative hearing — section 15.6(F)(5), quoted in full above.

Forty-two days per calendar year of paid non-medical and/or programmatic leave — 10 CCR 2505-10 8.400, section 8.482.44: "Medicaid will pay a nursing facility to hold a bed for non-medical and/or programmatic leave days up to a combined total of 42 days per resident per calendar year." Medical leave for a hospital stay carries no stated day limit in the sources reviewed, only the charge cap quoted 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 six sources in tools/packets/colorado-packet.txt by recipe (rebuilt 2026-09-19 to add source 6; sources 1-4 unchanged from 2026-08-30, source 5 re-fetched with only page-builder placeholder text differing, per the change log). Pending: the ombudsman program's own site (coloradoltcombudsman.org, not yet captured); any published form or address for an appeal to the Executive Director; a first-party statement, if one exists, of a resident's readmission or priority-of-return right beyond the bed-reservation term quoted in section 02.

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: Colorado Secretary of State, Code of Colorado Regulations (generated PDF) → https://web.archive.org/web/20260906132430/https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12005&fileName=6+CCR+1011-1+Chapter+05.

2026-09-19 — Deepened to a full page: section 01 (the grounds, as Colorado describes them) and section 02 (the published process, including the notice's required contents, bed-hold and return, and the notice-periods register) are now written. Newly captured: 10 CCR 2505-10 8.400, sections 8.482.42 through 8.482.44 (Medical Services Board, Department of Health Care Policy and Financing) — the Medicaid room-reservation ("bed hold") rule the 2026-08-30 baseline recorded as capture-pending (finding 5, below). It states a combined 42-day-per-calendar-year allowance for non-medical and/or programmatic leave, a separately defined "Medical Leave" for a hospital or other institutional stay with no stated day cap, a shared bed-reservation term for both ("The specific bed which the resident had occupied prior to leave must be reserved. No other resident may occupy the reserved bed."), and a per diem charge cap for medical leave. Transport: added to the standing recipe as source 6, using the same GenerateRulePdf.do mechanism as sources 1 through 4, addressed by its own ruleVersionId; captured by curl with a browser user-agent, sliced from section 8.482.42's heading through the end of 8.482.44 — see tools/recipes/colorado.json. The recipe was rerun in full (tools/capture.py colorado); sources 1 through 4 came back unchanged, and source 5 (the ombudsman page) came back with three short page-builder placeholder strings ("0", "Color Conditionals", "placeholder") no longer present — template cruft, not a change to the page's stated contacts, which are unaffected and unchanged. Retained as a rebuild per tools/retain-packet.py (hash 5df7e0e75286512c). Findings, continuing the numbering below: (8) No provision beyond the bed reservation itself — no separate readmission or priority-of-return statement — was found in either the licensing rule (section 5.2) or the Medicaid payment rule (8.482.42-44); the absence is stated in section 02 rather than assumed either way. (9) The licensing rule (5.2) requires a bed-hold policy with no day count of its own; the day counts live entirely in the Medicaid payment rule, a different publisher, and the two are quoted together without reconciling them into one number. Capture pending, continuing the 2026-08-30 list: the ombudsman program's own site; any published form or address for an appeal to the Executive Director. Internet Archive: not yet submitted for the new source. Reviewer: Carrie Schluter, reviewed 2026-09-20. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Colorado packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Colorado 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). Findings: (1) Colorado's appeal runs four steps with three different clocks — fourteen days to a staff designee, ten to the facility's grievance committee, ten to the executive director of the health department, then thirty days to request an administrative hearing. The first two steps are internal to the facility. No other state built so far routes a discharge appeal through the facility's own grievance committee before the state sees it. (2) The rule prints the appeal text the notice must carry, but with blanks: the staff designee, the division name, address and telephone number, and the ombudsman's numbers are left for the facility to fill in. The hearing row therefore states the ladder and its clocks, and states that the rule itself publishes no address. (3) Colorado defines discharge, transfer and room change as three different things, and gives the room change its own five-day written notice with its own appeal right. (4) A resident may not be moved until the notice period expires and the time for a grievance or appeal has expired or the grievance or appeal has been resolved — a stay stated as a condition on the move rather than as relief the resident must request. (5) The chapter's bed-hold provision, section 5.2, states no period at all: it requires the facility to develop a policy, give the resident a copy on admission, and explain it before each temporary absence. The Medicaid bed-hold rule at the health care policy department is capture-pending, and nothing is borrowed to fill the gap. (6) The department's ombudsman page states one telephone number and refers the reader to the ombudsman program's own site rather than reproducing its contacts; that site is capture-pending. (7) Two of the rule's notice blocks apply only where the resident has a developmental disability or a mental illness and an agency is authorised to advocate for them; both are captured and will be quoted in section 02. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.