Maine
- Grounds stated in the sources
- 10-144 CMR chapter 110, 10.Q.2: "The facility must permit each resident to remain in the unit or facility, and not transfer or discharge the resident from the unit or facility unless:" — "The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the unit or facility."; "The transfer or discharge is appropriate because the resident's health and/or functional ability has improved sufficiently so that the resident no longer needs the services provided by the unit or facility."; "The safety and/or health of individuals in the facility is 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. For a resident who becomes eligible for Medicaid after admission to a facility, the facility may charge a resident only charges allowable under Medicaid."; "The facility ceases to operate." The current MaineCare Benefits Manual states the same subject differently, in its own resident-rights section, 67.05-9(D): "A nursing facility must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility unless:" — "the transfer or discharge is necessary to meet the resident's welfare or medical needs and the resident's welfare or medical needs cannot be met in the facility;"; "the transfer or discharge is appropriate because the resident's health and/or functional abilities has improved sufficiently so the resident no longer needs the services provided by the facility; as determined by the resident's physician or a third party payor including Medicare and/or MaineCare;"; "the safety of individuals in the facility is endangered;"; "the health of individuals in the facility would otherwise be endangered as determined by the resident's physician;"; "the resident has failed, after reasonable and appropriate notice, to pay or have paid on his or her behalf (including MaineCare, Medicare) for the stay at the facility."; "the facility ceases to operate." Both lists are quoted as published and neither is reconciled here.
- Notice stated in the sources
- 10-144 CMR chapter 110, 10.Q.5: notice "must be made by the facility at least" "Thirty (30) days before the resident is transferred or discharged", except "As soon as practicable" where safety is endangered, health improves enough to allow a faster move, an urgent medical need requires it, or "A resident has not resided in the facility for thirty (30) days." Required contents (10.Q.4) include "The reason for the transfer or discharge, including events which are the basis for such action.", "The effective date of the transfer or discharge.", "Notice of the resident's right to appeal the transfer or discharge as set forth in the Maine Medical Assistance Manual.", "The mailing address and telephone number of the Long Term Care Ombudsman Program.", and "The resident's right to be represented by himself or herself or by legal counsel, a relative, friend or other spokesman." The MaineCare Benefits Manual states the same notice requirement, 67.05-9(E): "Written notice must be made at least thirty (30) days in advance of the resident's transfer or discharge except" the same categories of exception, and requires the notice to carry "the mailing address and telephone number of the State Long-term Care Ombudsman Program which is: P.O. Box 2723, Augusta, Maine 04333, 1-800-499-0229 (in-state only) and (207) 621-1079 (local and out-of state)".
- Hearing office in these sources
- 10-144 CMR chapter 110, 10.Q.6: "The resident has the right to appeal a transfer or discharge to the Administrative Hearings Unit of the Department." The MaineCare Benefits Manual, 67.05-9(G), names the office and the route: "A notice of intent to transfer or discharge (see Section 67.05-9(E)) shall include a statement that any resident has the right to appeal a decision to transfer or discharge to the Office of Administrative" — the text continues across the manual's own repeated page header — "Hearings, Department of Health and Human Services. To challenge the transfer or discharge, submit a request in writing to the:" "The Office of Administrative Hearings" "Department of Health and Human Services" "11 State House Station" "Augusta, Maine 04333-0011". On timing and pendency: "Hearings will be held on an expedited basis and a written decision will be rendered within three (3) working days" and "A facility may not transfer or discharge a resident until a decision is rendered if that resident has requested a hearing within ten (10) days of receipt of notice" (with two stated exceptions). The department's general Administrative Hearings page gives the same office's contact as "109 Capitol Street" "11 State House Station" "Augusta, ME 04333-0011" and "TEL: (207) 624-5350" — an address that differs from the one printed inside the manual's own transfer-and-discharge hearing text, shown as published and not reconciled. The department's general fair-hearing FAQ states, of DHHS hearings generally rather than of this hearing specifically: "You generally have 30 days to appeal for a hearing."
- Ombudsman in these sources
- The Maine Long-Term Care Ombudsman Program states of itself: "The Maine Long-Term Care Ombudsman Program is a non-profit agency whose mission is to advocate for quality of life and care for long-term care consumers." Its staff directory names "Brenda Gallant" as "Executive Director" and "State Long-Term Care Ombudsman". Its own published contact: "61 Winthrop St." "Augusta, ME 04330", "(207) 621-1079" (local), "(800) 499-0229" (toll free), "(207) 621-0509" (fax), "MLTCOP@MaineOmbudsman.org". The MaineCare Benefits Manual instead prints the program's address as "P.O. Box 2723, Augusta, Maine 04333" — both addresses shown as published, not reconciled.
- Sources last checked
- Oct 8, 2026
Reproduced from the agencies' own pages and documents quoted below — potentially relevant official sources, not a determination that any notice, ground, or deadline applies to any situation.
Lede
This page assembles what Maine's own publishers state about involuntary transfer and discharge from a nursing facility. The fullest single source is 10-144 CMR chapter 101, the MaineCare Benefits Manual, Chapter II, Section 67 (Nursing Facility Services), whose own page header states it was "ESTABLISHED 7/1/91" and "LAST UPDATED 9/15/15" — it states the grounds, the thirty-day notice and its exceptions, the notice's required contents, the hearing office and its filing address, an expedited-decision and pendency structure, and a Medicaid bed-hold day count, all in one chapter. Maine's licensing rule, 10-144 CMR chapter 110 (effective August 1, 2020), states the same subjects in its own resident-rights section under the same vocabulary — transfer and discharge — with its own, differently worded list of permitted grounds.
Both current rules state the grounds twice, in two different documents with two different lists, and the hearing route is stated with two different addresses for the same office. Neither is reconciled here. The federal floor for Medicare/Medicaid-certified facilities is assembled separately on the federal page; nothing here fills a gap from federal law or another state. Confirm applicability with the agencies named in the sources: whether any provision applies to a particular facility, resident, or notice is for the hearing office to determine. Deadlines and periods on this page are quoted from the sources, not calculated for any case.
The grounds, as Maine describes them
10-144 CMR chapter 110, 10.Q.2, Transfer and Discharge Requirements, states, in the rule's own order: "The facility must permit each resident to remain in the unit or facility, and not transfer or discharge the resident from the unit or facility unless:"
a. "The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the unit or facility."
b. "The transfer or discharge is appropriate because the resident's health and/or functional ability has improved sufficiently so that the resident no longer needs the services provided by the unit or facility."
c. "The safety and/or health of individuals in the facility is endangered."
d. "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. For a resident who becomes eligible for Medicaid after admission to a facility, the facility may charge a resident only charges allowable under Medicaid."
e. "The facility ceases to operate."
The current MaineCare Benefits Manual states the same subject differently, at 67.05-9(D), Resident Transfer and Discharge Rights: "A nursing facility must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility unless:"
1. "the transfer or discharge is necessary to meet the resident's welfare or medical needs and the resident's welfare or medical needs cannot be met in the facility;"
2. "the transfer or discharge is appropriate because the resident's health and/or functional abilities has improved sufficiently so the resident no longer needs the services provided by the facility; as determined by the resident's physician or a third party payor including Medicare and/or MaineCare;"
3. "the safety of individuals in the facility is endangered;" — not itself numbered in the manual's own text, reproduced exactly as the document renders it.
4. "the health of individuals in the facility would otherwise be endangered as determined by the resident's physician;"
5. "the resident has failed, after reasonable and appropriate notice, to pay or have paid on his or her behalf (including MaineCare, Medicare) for the stay at the facility. Conversion from private pay rate to payment at the MaineCare rate does not constitute non-payment. For a resident who becomes eligible for MaineCare after admission to a facility, the facility may charge a resident only allowable charges under MaineCare; or"
6. "the facility ceases to operate. In the event a NF ceases to operate and the member is to be transferred to another NF, the member must accept the first available placement that is appropriate to meet his or her medical care needs within a sixty (60) miles radius of the member's home, (or the NF, if this is considered home) or MaineCare reimbursement will cease. The member may accept a placement beyond the sixty (60) miles radius, however, this cannot be required."
Both lists are quoted here as published, in each document's own order and vocabulary, and neither is reconciled with the other.
The published process
Requesting the hearing
10-144 CMR chapter 110, 10.Q.6, Appeal of Transfer or Discharge, states: "The resident has the right to appeal a transfer or discharge to the Administrative Hearings Unit of the Department." The MaineCare Benefits Manual, 67.05-9(G), Hearings, names the office and the route: "A notice of intent to transfer or discharge (see Section 67.05-9(E)) shall include a statement that any resident has the right to appeal a decision to transfer or discharge to the Office of Administrative" — the text continues across the manual's own repeated page header — "Hearings, Department of Health and Human Services. To challenge the transfer or discharge, submit a request in writing to the:" "The Office of Administrative Hearings" "Department of Health and Human Services" "11 State House Station" "Augusta, Maine 04333-0011".
The pendency provision is stated at 67.05-9(G): "A facility may not transfer or discharge a resident until a decision is rendered if that resident has requested a hearing within ten (10) days of receipt of notice" unless "the health or safety of individuals is in immediate risk and cannot be otherwise protected until a decision is rendered (see Section 67.05-9(D) (3) and (4))" or "immediate transfer or discharge is necessitated by the resident's urgent medical need (see Section 67.05-9(D)(1))." The same subsection states the decision timeline: "Hearings will be held on an expedited basis and a written decision will be rendered within three (3) working days. The decision by The Office of Administrative Hearings is enforceable following two (2) working days of the written decision, unless the resident has appealed the decision in court. The appeal must be submitted within two (2) working days. A facility decision to transfer or discharge will be upheld if consistent with the standard set forth in Section 67.05-9(D), (E), and (F)." The manual adds that "Hearings will be held as described in Chapter I of this Manual unless inconsistent with this Section in which case this Section shall govern."
The notice's required contents
10-144 CMR chapter 110, 10.Q.4, Contents of the Notice, requires the notice to include "The reason for the transfer or discharge, including events which are the basis for such action.", "The effective date of the transfer or discharge.", "Notice of the resident's right to appeal the transfer or discharge as set forth in the Maine Medical Assistance Manual.", "The mailing address and telephone number of the Long Term Care Ombudsman Program.", and "The resident's right to be represented by himself or herself or by legal counsel, a relative, friend or other spokesman." The MaineCare Benefits Manual states its own parallel list at 67.05-9(E)(3): "the reason for the transfer or discharge including events that are the basis for such action;" "the effective date of the transfer or discharge;" "the location to which the resident is transferred or discharged;" "notice of the resident's right to appeal the transfer or discharge as set forth in Section 67.05-9(G);" "the mailing address and telephone number of the State Long-term Care Ombudsman Program which is: P.O. Box 2723, Augusta, Maine 04333, 1-800-499-0229 (in-state only) and (207) 621-1079 (local and out-of state);" and "the resident's right to be represented by him or herself or by legal counsel, a relative, friend or other spokesperson." On timing, 67.05-9(E)(2) states: "Written notice must be made at least thirty (30) days in advance of the resident's transfer or discharge except" the same categories of exception stated in section 01, and adds that "oral notice shall be provided immediately to the resident, his/her legal representative, or a family member (if they are able to be contacted) unless the discharge meets the exceptions."
Bed-hold and return
The MaineCare Benefits Manual, 67.05-11, Prior Approval for Payment of Bed Holds During a Hospitalization, states: "All nursing facilities must provide written information to the member and a family member or legal representative that specifies the Department's bed hold policy and the facility's bed hold policy before the member is transferred to a hospital and at the time of transfer." On the day count, 67.05-11(C) states: "Effective March 25, 2013, payment of bed holds for a semi-private room for a short-term hospitalization of the member shall be granted up to four (4) days (midnights) absence through March 31, 2013, as long as the member is expected to return to the nursing facility. Effective April 1, 2013, payment for bed holds shall be granted up to seven (7) days (midnights) absence per inpatient hospitalization absence, as long as the member is expected to return to the nursing facility." On return, 67.05-11(B) states: "A NF shall provide a member with the opportunity for readmission following hospitalization, if the individual remains a MaineCare member." The manual separately addresses therapeutic leave at 67.05-12: nursing facilities "are responsible for informing residents in writing of their right to one (1) overnight leave of absence through March 31, 2013" and, in later periods stated in the text, to "twenty (20) therapeutic overnight leaves of absence from April 1, 2013 through June 30, 2013", with the day counts changing across several 2013-and-later effective-date windows, and the standing caution that "A leave of absence may not be used to extend a bed hold during a hospital stay."
The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Maine'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, with four exceptions — 10-144 CMR chapter 110, 10.Q.5: the notice "must be made by the facility at least" "Thirty (30) days before the resident is transferred or discharged", except "As soon as practicable" where "The safety and/or health of individuals in the facility would be endangered." or "The resident's health improves sufficiently to allow a more immediate transfer or discharge." or "An immediate transfer or discharge is required by the resident's urgent medical needs," or where "A resident has not resided in the facility for thirty (30) days." The MaineCare Benefits Manual states the same period at 67.05-9(E)(2), quoted in full in section 02.
Ten days to request a hearing, for the pendency provision to apply — 67.05-9(G), quoted in full in section 02.
Three working days to a decision, two working days to enforceability, two working days to appeal it in court — 67.05-9(G), quoted in full in section 02.
Thirty days to appeal generally, per the department's own fair-hearing FAQ, stated of DHHS hearings generally rather than of this hearing specifically: "You generally have 30 days to appeal for a hearing."
Seven bed-hold days (midnights) per inpatient hospitalization absence, effective April 1, 2013 — 67.05-11(C), quoted in full in section 02.
Seven days to complete a Discharge Tracking Form after a discharge event — 67.05-9(A): "a Discharge Tracking Form is to be completed within seven (7) days of the event."
What any of these periods means for a particular case is for the hearing office or relevant state process to determine.
Source map
| Document | Publisher and location | Source's own date | Retrieved |
|---|---|---|---|
| 10-144 CMR chapter 110, Regulations Governing the Licensing and Functioning of Skilled Nursing Facilities and Nursing Facilities (Section 10.Q, Transfer and Discharge Rights) | Maine Secretary of State, Bureau of Corporations, Elections and Commissions | Effective August 1, 2020 | 2026-09-01 |
| 10-144 CMR chapter 101, MaineCare Benefits Manual, Chapter II, Section 67, Nursing Facility Services (67.05-9, 67.05-10, 67.05-11, 67.05-12, 67.05-18) | Maine Department of Health and Human Services / Secretary of State | header: "SECTION 67 NURSING FACILITY SERVICES ESTABLISHED 7/1/91" and "LAST UPDATED 9/15/15"; filename: "LUP 09.15.2014" | 2026-09-01 |
| Administrative Hearings | Maine Department of Health and Human Services | none stated on page | 2026-09-01 |
| Administrative Hearings — Frequently Asked Questions | Maine Department of Health and Human Services | none stated on page | 2026-09-01 |
| Maine Long-Term Care Ombudsman Program (home page) | Maine Long-Term Care Ombudsman Program | none stated on page | 2026-09-01 |
| Contact, Advocacy Intake Office & Winthrop Street Headquarters | Maine Long-Term Care Ombudsman Program | none stated on page | 2026-09-01 |
| Our Team (staff directory) | Maine Long-Term Care Ombudsman Program | none stated on page | 2026-09-01 |
Captured: all seven, in tools/packets/maine-packet.txt (unchanged since 2026-09-01; see 2026-09-24 change-log entry for why — a recipe defect blocks an automated recapture, and all seven were instead spot-verified by hand against fresh fetches). Pending: Maine statute (Title 22) provisions, if any, independently enumerating involuntary-discharge grounds or an appeal deadline; a current, renamed-agency version of the "Office of Advocate, Department of Mental Health, Mental Retardation and Substance Abuse Services" that chapter 110 still names; Chapter I of the MaineCare Benefits Manual, which the hearings sections point to for general procedure; a first-party page reconciling the ombudsman program's two published addresses; and Internet Archive submission — per the packet's pending list.
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: Maine Long-Term Care Ombudsman Program → https://web.archive.org/web/20261016051633/https://www.maineombudsman.org/; Maine Long-Term Care Ombudsman Program → https://web.archive.org/web/20261016051806/https://www.maineombudsman.org/contact.aspx.
2026-09-24 — Deepened to a full page: sections 01 and 02 written from evidence already in the standing packet, no new sources added. Attempting to recapture through the existing recipe (tools/recipes/maine.json) before writing surfaced two tooling problems rather than any source drift. First, sources 1 and 2 (both .docx files) were declared with extractor html-text/scope body, which cannot work against a Word document and errors immediately; the true transport, already documented in the 2026-09-01 entry below, is python-docx. Fixed the recipe's extractor to docx/paragraphs-and-tables to match. Second, fixing that exposed that this repository's pinned capture environment, tools/.venv, has no docx package installed at all — capture.py --preflight checks the poppler and pdfplumber pins it uses but says nothing about this gap — so the recipe still cannot run end to end here, and separately has no slice for sources 1 or 2, meaning even a working extractor would fetch the entire chapter and the entire manual rather than the sections the standing packet holds. None of this is new evidence: it is a recipe that was never finished past draft-recipe.py's first pass (its notes still read "DRAFT — replace before promoting" on every source). Worked around without an automated recapture and without touching capture.py: fetched sources 1 and 2 by hand, extracted them with a system Python that has python-docx installed (the same paragraphs-then-tables convention extract_docx uses), and confirmed every quotation this page draws from them — both grounds lists, the notice and its exceptions, the hearing office and its pendency and decision-timeline provisions, and the bed-hold day count — is present verbatim in the fresh full-document text. Sources 3 through 7 were separately re-fetched through the recipe's own (still-imprecise) HTML transport and likewise checked: every existing quotation from those five sources is present in the fresh fetch as well. No source has moved or changed; the standing packet is untouched, and no new packet was promoted. Filed as FA-Q-20260924-04 in the field-assembly-standard handoff queue and in this repo's QUEUE.md; not fixed further here, per this routine's rule against modifying tooling. Both pages check at zero failures against the standing seven-source packet. Reviewer: Carrie Schluter, reviewed 2026-09-24. Corrections: hello@fieldassembly.net.
2026-09-01 — Baseline page built from the first Maine packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Maine 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: Source 1 (10-144 CMR chapter 110) and Source 2 (10-144 CMR chapter 101, Chapter II, Section 67) were retrieved as .docx files from maine.gov/sos by curl with a browser user-agent and converted to text with python-docx, reading document paragraphs directly (no OCR; both are native Word documents, not scanned images); the running page header "67.05 POLICIES AND PROCEDURES (cont.)" that recurs mid-section in Source 2 is the manual's own repeated header, reproduced as extracted. Sources 3-7 were retrieved by curl with a browser user-agent and extracted by stripping HTML tags and collapsing whitespace, mechanically. Findings: (1) The two current rules state the grounds differently: chapter 110's licensing-rule list (five items, framed around "welfare," "improved," "endangered," "failed to pay," "ceases to operate") and the MaineCare Benefits Manual's resident-rights list (six items, splitting facility-endangerment from resident-health-endangerment into two separate grounds); both are quoted as published and neither is reconciled here. (2) In the MaineCare Benefits Manual's own current text, the grounds list's third item — "the safety of individuals in the facility is endangered;" — is not itself numbered, where the surrounding items are numbered 1, 2, 4, 5 and 6; this is reproduced exactly as the document's extracted text renders it, with no correction attempted, on the same reasoning as this project's other transcription-artifact findings. (3) The MaineCare Benefits Manual states the hearing office's address two different ways within Section 67 itself: 67.05-9(G), governing a transfer-or-discharge appeal, gives "The Office of Administrative Hearings" "Department of Health and Human Services" "11 State House Station" "Augusta, Maine 04333-0011", while 67.05-18(A), governing an appeal of "any classification decision", directs a letter instead to "the Director of the Office of Elder Services, Department of Health and Human Services, 11 State House Station, Augusta, Maine 04333-0011" — two different named recipients at the same street address, for what the text treats as two different kinds of appeal; both are quoted as published and not reconciled. The department's general Administrative Hearings page gives the Division of Administrative Hearings' own address as "109 Capitol Street" "11 State House Station" "Augusta, ME 04333-0011", a third address, also not reconciled. (4) Chapter 110's notice-contents subrule still names, for residents with developmental disabilities or mental illness, "the mailing address and telephone number of the Office of Advocate, Department of Mental Health, Mental Retardation and Substance Abuse Services" — a department name Maine has not used in decades. No first-party page giving a current name and contact for this specific notice requirement was located; the rule is quoted as published, and the outdated name is not corrected here. (5) The Long-Term Care Ombudsman Program's own site publishes its address as "61 Winthrop St." "Augusta, ME 04330"; the MaineCare Benefits Manual instead prints "P.O. Box 2723, Augusta, Maine 04333" as the address a facility's notice must carry. Both are quoted as published and not reconciled. (6) The MaineCare Benefits Manual, 67.05-11(C), states a concrete Medicaid bed-hold structure: "Effective April 1, 2013, payment for bed holds shall be granted up to seven (7) days (midnights) absence per inpatient hospitalization absence, as long as the member is expected to return to the nursing facility." This is not a docket row on a baseline page and is not asserted here as the state's bed-hold rule; it is captured now for section 02. (7) The Maine Long-Term Care Ombudsman Program states of itself, "The Maine Long-Term Care Ombudsman Program is a non-profit agency" — captured per this project's ombudsman rule, which allows a designated non-state program's own published contact to stand in the ombudsman row, checked here against its own about-us page rather than assumed. (8) Source 2's own header states "LAST UPDATED 9/15/15" while the file's own name, as published by the Secretary of State, carries "LUP 09.15.2014" — a one-year discrepancy between two statements the same publisher makes about the same document's currency; both are quoted in the source map and not reconciled. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-01. Corrections: hello@fieldassembly.net.