Delaware

The grounds, as Delaware describes them

16 Del. Admin. Code § 3102-3.1 (Delaware Administrative Code, regulations.delaware.gov, PDF, 16 DE Reg. 296 (09/01/12), retrieved 2026-09-26), for residents of "a certified skilled nursing facility or a certified nursing facility as defined in 42 CFR §483.5 or an Intermediate Care facility (ICF/MR) as defined in 42 CFR §440.150", states: "The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless—", in the regulation's own order:

"The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility."

"The transfer or discharge is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility;"

"The safety of individuals in the facility is endangered;"

"The health of individuals in the facility would otherwise be endangered;"

"The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility."

"The facility ceases to operate."

A second list in the same current regulation, § 3102-4.2, states the grounds differently for residents of "a Nursing Facility and Similar Facility as defined in 16 Del.C. 1102(4)": the facility "must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility except for:"

"Medical needs which cannot be met in the facility;"

"The resident's own welfare;"

"The welfare of the other individuals in the facility;"

"Nonpayment of justified charges, after appropriate notice;"

"Termination of facility operation."

Both lists are current and both are quoted as published; the regulation does not say which applies to a given facility beyond the two definitions above, and this page does not reconcile them.

The published process

Requesting the hearing

§ 3102-5.1.1: "An impartial hearing may be requested by a resident who believes a facility has erroneously determined that he or she must be transferred or discharged." The hearing request must "Be in writing;", "Be received by the facility within 30 days from the date that the discharge notice is received by the resident or the resident’s legal representative;", and "Be copied to the Division and the State LTC ombudsman." The regulation names no separate filing address, form, or administrative-hearings office beyond the facility itself and those two copies. On pendency, § 3102-3.1.1 states, of a transfer or discharge based on the resident's-welfare ground: "If the resident appeals a notice of discharge based on this section, the facility will not be cited during the pendency of the appeal for housing a resident whose needs exceed the permitted level of care in that facility." The regulation states no equivalent pendency sentence for the other five grounds at § 3.1 or for the § 4.2 track. § 5.2 states two circumstances in which "DHSS may deny or dismiss a request for a hearing": "The resident withdraws the request in writing; or" "The resident or his or her legal representative fails to appear at a scheduled hearing without good cause." § 5.10.2 states that the impartial fact-finder's decision is "the final decision of DHSS with the right to an appeal pursuant to the Administrative Procedures Act, Title 29, Chapter 101."

The notice's required contents

§ 3102-3.5, for the § 3.0 track, states the written notice "must include the following:" "A detailed individualized explanation of the reason(s) for the action being taken which includes, in terms understandable to the resident:" a statement of the intended action, the reasons for it including, "When the reason is non-payment, an itemized statement of the resident’s account for the preceding 12 months", and "The specific policy or regulation supporting such action."; "The effective date of transfer or discharge;"; "The location to which the resident will be transferred or discharged;"; "A statement of the resident’s right to a fair hearing as provided in this section;"; "The method by which the resident may request a fair hearing;"; "A statement that the resident may represent him or herself or may be represented by counsel or by another person."; and "The name, address and telephone number of the State long term care ombudsman;". § 3102-4.6, for the § 4.0 track, states substantially the same list with one addition: "For nursing facility residents with a developmental disability or mental illness, the mailing address and telephone number of the Delaware protection and advocacy agency as defined in Title 16 Del.C. §1102." Both tracks' § 3.3 and § 4.4 require the facility to "Notify the resident and, if known, a family member or legal representative of the resident of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand." A copy of that notice must also go, per § 3.3.2: "Provide a copy of the notice to the Division; the State LTC ombudsman; the resident’s Delaware Medicaid managed care organization (MCO), if any; any DHSS agency involved in the resident’s placement in the facility, including APS; and the protection and advocacy agency as defined in Title 16 Del.C. §1102 if the resident is an individual with a developmental disability or mental illness."

Bed-hold and return

§ 3102-3.9.1: before a transfer to a hospital or therapeutic leave, the nursing facility must give written information specifying "Notice of State bed-hold. The duration of the bed-hold policy under the State plan, if any during which the resident is permitted to return and resume residence in the nursing facility, See DHSS Long Term Care Institutional Provider Specific Policy Manual at Section 4.5" and "Facility policies. The nursing facility's policies regarding bed-hold periods". That manual's own Section 4.5 (Long Term Care Institutional Provider Specific Policy Manual, Delaware Division of Medicaid & Medical Assistance, PDF, Revision Table: 02/01/2023 manual-wide, Section 4.5 last revised 9/1/2016, retrieved 2026-09-26) states: "If a member is hospitalized for a short period of time and is expected to return to the LTC facility, payment may continue for a period of not more than 7 days provided that the LTC facility agrees to hold the bed for the resident." and "DMAP reimbursement is available for only 7 days within each 30-day period." A separate rate applies to an Intermediate Care Facility for Individuals with Intellectual Disabilities: "payment may continue for a period of not more than 14 days provided that the ICF/IID agrees to hold the bed for the resident." with DMAP reimbursement likewise "available for only 14 days within each 30-day period for members residing in an ICF/IID." On return, § 3102-3.9.3 requires the facility to "establish and follow a written policy under which a resident, whose hospitalization or therapeutic leave exceeds the bed-hold period under the State plan, is readmitted to the facility immediately upon the first availability of a bed in a semi-private room" if the resident "Requires the services provided by the facility" and "Is eligible for Medicaid nursing facility services." The § 4.0 track states a different return right at § 3102-4.10.1 and 4.10.2: the facility must provide written information specifying "that the facility must accept the patient or resident back into the facility when the resident no longer needs acute care and there is space available in the facility. If no space is available, the resident shall be accepted into the next available bed." and the facility must "establish and follow a written policy for implementing its obligation to immediately offer the first available bed to a resident who is entitled to be readmitted to the facility when acute care is no longer required." Neither track's own bed-hold text states a day count for the § 4.0 track separately from the Section 4.5 manual quoted above.

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

30 days' advance notice — § 3102-3.4.1 and, in the § 4.0 track's own wording, § 3102-4.5: both state that the notice "must be made by the facility at least 30 days before the resident is transferred or discharged." Notice "may be made as soon as practicable before transfer or discharge" under § 3.4.2 when safety or health of others in the facility would be endangered, the resident's health has improved sufficiently to allow a more immediate move, or an immediate move is required by urgent medical needs; § 4.5.1 states the equivalent as-soon-as-practicable circumstances for the § 4.0 track, adding "or after transfer or discharge" to that track's own wording.

30 days to request the hearing — § 3102-5.1.1.2: the hearing request must "Be received by the facility within 30 days from the date that the discharge notice is received by the resident or the resident’s legal representative;".

7 days' bed-hold (nursing facility) — DHSS Long Term Care Institutional Provider Specific Policy Manual § 4.5.1 and § 4.5.1.1, quoted in full above: payment "may continue for a period of not more than 7 days" provided the facility agrees to hold the bed, with DMAP reimbursement "available for only 7 days within each 30-day period."

14 days' bed-hold (ICF/IID) — the same manual, § 4.5.2 and § 4.5.2.1: payment "may continue for a period of not more than 14 days" provided the ICF/IID agrees to hold the bed, with DMAP reimbursement "available for only 14 days within each 30-day period for members residing in an ICF/IID."

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

Source map

Captured: all four, in tools/packets/delaware-packet.txt. Pending: any Delaware statute establishing the Long-Term Care Ombudsman program by its own text, and any first-party statement of a specific hearing-request address or form beyond the regulation's own instructions.

Change log

2026-10-16 — Internet Archive captures recorded. Captures requested this date by an automated capture pass; 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: Long Term Care Institutional Provider Specific Policy Manual, Delaware Division of Medicaid & Medical Assistance, PDF → https://web.archive.org/web/20261016044430/https://medicaidpublications.dhss.delaware.gov/docs/DesktopModules/Bring2mind/DMX/API/Entries/Download?Command=Core_Download&EntryId=900&language=en-US&PortalId=0&TabId=94.

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: Delaware Health and Social Services → https://web.archive.org/web/20260906133015/https://dhss.delaware.gov/dhcq/dhcq/contact/; Delaware Health and Social Services, Office of the Secretary → https://web.archive.org/web/20260906133119/https://dhss.delaware.gov/office-of-the-secretary/long-term-care-ombudsman-program/.

2026-09-26 — Deepened to a full page. Newly captured: the DHSS Long Term Care Institutional Provider Specific Policy Manual, Section 4.5 (added as source 4 of tools/recipes/delaware.json; standing packet recaptured, digest f5369fe37370), located by probing medicaidpublications.dhss.delaware.gov's DNN download endpoint by EntryId until the Content-Disposition filename and the document's own running header matched the regulation's citation. Transport: plain curl with a browser user-agent, HTTP 200, application/pdf; pdftotext -layout, sliced from the Section 4.5 body heading (occurrence 2, after the manual's own table of contents) to the Section 4.6 heading. The other three sources were recaptured through the standing recipe and reproduce byte-for-byte. Findings, continuing the numbering of the 2026-09-03 entry: (6) The manual's Section 4.5 states a 7-day DMAP-reimbursed bed-hold for a nursing facility and a 14-day bed-hold for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), each per 30-day period — a state Medicaid payment policy, not a resident's own maximum absence; the regulation's own bed-hold return right (§ 3102-3.9.3) is not itself keyed to a day count, only to the "bed-hold period under the State plan" this manual states. (7) The § 4.0 track (Nursing Facility and Similar Facility) states its own return-to-facility right at § 3102-4.10 in different terms from the § 3.0 track's § 3102-3.9/3.10 — a facility obligation to accept the resident back with space available, or into the next available bed, with no day count of its own — and neither track's regulation text states a bed-hold day count separately from the Section 4.5 manual; both are quoted and not reconciled. Capture-pending, unchanged: any Delaware statute establishing the Long-Term Care Ombudsman program by its own text, and any first-party statement of a specific hearing-request address or form beyond the regulation's own instructions. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-27. Corrections: hello@fieldassembly.net.

2026-09-03 — Baseline page built from the first Delaware packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Delaware 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). Transport: 16 Del. Admin. Code § 3102 was retrieved as a PDF directly from regulations.delaware.gov's own document API (the friendly HTML page at that address renders only a client-side application shell to curl); the two dhss.delaware.gov pages were retrieved by ordinary curl with a browser user-agent, neither Cloudflare-obfuscated. Findings: (1) The regulation states two parallel grounds lists for two different categories of facility in the same current text — six circumstances at § 3102-3.1 for certified skilled nursing, nursing, and ICF/MR facilities, and five at § 3102-4.2 for "Nursing Facility and Similar Facility" residents defined at 16 Del.C. § 1102(4); both are quoted as published and neither is reconciled here. (2) The regulation's own definitions name "the Division" as "the Division of Long Term Care Residents Protection." — a name that does not appear anywhere on the department's current site; nursing-facility complaints, oversight, and (per § 3102-3.3.2) the required copy of a transfer or discharge notice are instead directed by the current site to the Division of Health Care Quality (DHCQ). Both are quoted as published and not reconciled; this page uses DHCQ's current published contact where the regulation names "the Division." (3) The regulation names no separate administrative-hearings office, filing address, or hearing-request form: a resident's hearing request is filed with the facility itself and copied to the Division and the state ombudsman, per § 3102-5.1.1. If DHCQ or another Delaware office publishes a dedicated hearing-request address or form, it was not located in this pass. (4) § 3102-3.9.1.1 points to the "DHSS Long Term Care Institutional Provider Specific Policy Manual at Section 4.5" for the state bed-hold duration; that manual was not captured in this pass, a transport/search gap rather than a finding that Delaware states no bed-hold policy, and it belongs to a future full-page build. (5) The Long-Term Care Ombudsman Program's own contact page prints its email address in two capitalizations — "DHSS_OSEC_Ombudsman@Delaware.gov" and "DHSS_OSEC_Ombudsman@delaware.gov" — both quoted as published and not reconciled. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-03. Corrections: hello@fieldassembly.net.