Maryland

The grounds, as Maryland describes them

Health-General § 19-345(a) states, in the statute's own order (Maryland General Assembly, retrieved 2026-09-16): "A resident of a facility may not be transferred or discharged from the facility involuntarily except for the following reasons:"

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

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

(3) "The health or safety of an individual in a facility is endangered;"

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

(5) "The facility ceases to operate."

COMAR 10.07.09.10A states the same five grounds in the regulation's own wording, with one addition to the fifth: a facility may not involuntarily transfer or discharge a resident unless the transfer or discharge falls within one of five conditions, the last reading "Nursing facility ceases to operate or, in the case of a resident who receives Medicare or Medicaid services, when the nursing facility has been decertified or has withdrawn from the Medicare or Medicaid Program." Both texts stand as published, reconciled nowhere; see finding (1) in the change log.

The statute separately bars a Medicaid-certified facility from using Medicaid status itself as a ground: Health-General § 19-345(b)(1) states "A Medicaid certified facility may not:", with clause (ii) reading "Transfer or discharge a resident involuntarily because the resident is a Medicaid benefits recipient." Subsection (b)(2)(i) states that, with a stated exception for nonpayment while a resident was ineligible, "a Medicaid certified facility is presumed to be transferring or discharging a resident in violation of this subsection, if the resident is or becomes eligible for Medicaid benefits."

COMAR 10.07.09.10B states a related right stated alongside the grounds: "A resident has a right to request a hearing on the proposed transfer or discharge, except when the transfer or discharge is being taken pursuant to §A(5) of this regulation" — the facility-ceases-to-operate or decertification ground.

The published process

Requesting the hearing

COMAR 10.07.09.13A: "A resident may request a hearing within 30 days of receiving a notice of an intended involuntary transfer or discharge as provided in Regulation .10C of this chapter." On route, 10.07.09.13C(1): "The resident shall send a written request for a hearing to the Office of Administrative Hearings by the 30th calendar day after the resident receives the nursing facility's notice of the proposed transfer or discharge." No street address, telephone number, or form for that office is stated in the sources reviewed; see the change log. After a request is filed, 10.07.09.13C(2)–(3): "the Office of Administrative Hearings shall schedule a hearing" and "shall conduct the hearing in accordance with COMAR 10.01.04 and 28.02.01."

The pendency statement is at 10.07.09.13B: "Except in an emergency or when the resident has resided in a facility for less than 30 days, after a request for a hearing has been filed, a nursing facility may not discharge or transfer the resident until: (1) A final decision is issued after the hearing and all requirements of Regulation .11 of this chapter are met; or (2) The resident consents to the discharge or transfer and withdraws the request for a hearing."

Maryland states who the parties are, and states the hearing's own procedural character: 10.07.09.13C(4): "The Department is not a party to a hearing conducted pursuant to this regulation. The parties are the nursing facility and the resident. Therefore, a hearing conducted pursuant to this regulation is not a contested case as defined in the Administrative Procedure Act, State Government Article, §10-202, Annotated Code of Maryland." Where nonpayment is the stated basis, 10.07.09.13D permits a facility to require an escrow account "when the: (1) Basis for a resident's discharge is nonpayment; and (2) Resident continues to reside in the facility pending a final decision."

The notice's required contents

COMAR 10.07.09.10D: "The required notice to a resident under this regulation shall be on a form developed by the Department and shall include:"

(1) "Each reason for the proposed transfer or discharge;"

(2) "A statement that the resident has the right to request a hearing on a proposed transfer or discharge, and how to request a hearing pursuant to Regulation .13 of this chapter, except in the case of a discharge made pursuant to §A(5) of this regulation;"

(3) "The name, address, and telephone number of the State's Office on Aging and local office on aging long-term care ombudsman;"

(4) "The right of a resident to consult with any lawyer the resident chooses;"

(5) "The name, address, and telephone number of the Legal Aid Bureau, The Older American Act Senior Legal Assistance Programs, and other agencies that may provide assistance to individuals who need legal counsel;"

(6) "For nursing facility residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled individuals;"

(7) "For nursing facility residents who are mentally ill, the mailing address and telephone number of the agency responsible for the protection and advocacy of mentally ill individuals;"

(8) "The effective date of the proposed transfer or discharge which, except as set forth in §C of this regulation, is at least 30 days after receiving the notice and at least 60 days after receipt of the notice if the nursing facility is part of a continuing care retirement center; and"

(9) "The resident's rights concerning discharge, as set forth in Regulation .11 of this chapter."

COMAR 10.07.09.11B further states what a facility must provide "at the time of transfer or discharge" — with an exception at §D for certified continuing care facilities — including "A written statement of the medical assessment and evaluation and post-discharge plan of care", "A written statement itemizing the medications currently being taken by the resident", "at least a 3-day supply of the medications currently being taken by the resident" to the extent permitted by federal and state law, information to help obtain further prescriptions, and "A written statement containing the date, time, method, mode, and destination of the resident's discharge."

Bed-hold and return

COMAR 10.07.09.12C states two notice duties. At admission: "At the time of admission, a nursing facility shall provide written information to a resident or, when applicable, the resident's representative or interested family member, describing the facility's bed-hold policy, including the period of time during which the resident is permitted to return and resume residence in the nursing facility." At transfer: "At the time of transfer of a resident to a hospital or for therapeutic leave, a nursing facility shall provide a written notice to the resident, or when applicable, the resident's representative or interested family member, which specifies the duration of the bed-hold policy described in §C of this regulation."

On return, 10.07.09.12D: "When a resident's hospitalization or therapeutic leave exceeds the bed-hold period under the State Medicaid plan, the resident has a right to be readmitted to the nursing facility immediately upon the first availability of a bed in a semiprivate room if the resident: (1) Requires the services provided by the nursing facility; and (2) Is eligible for Medicaid coverage for the nursing facility's services." The regulation names the bed-hold period's source as "the State Medicaid plan" but does not itself state the number of days; a search of COMAR Title 10, Subtitle 09, Chapter 10 (Nursing Facility Services, the Medicaid provider chapter) — its chapter index and its Regulation .01 definitions — located no provision stating a reserved-bed-day count. That absence is stated rather than filled from another source or another state.

10.07.09.12E states a related protection: "Unless the bed hold has expired, for purposes of this regulation, transfer includes the refusal of a nursing facility to accept the return of a resident who was previously transferred from the nursing facility: (1) Whose bed at the nursing facility was continuously reserved or required to be reserved through payment to the nursing facility from any source; or (2) Who had an application for medical assistance pending at the time of the transfer if there is no reason to believe that the application will not be approved."

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Maryland'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 or sixty days' advance notice — COMAR 10.07.09.10C(1): "the nursing facility shall notify the resident, representative, or interested family member, the State Long-Term Care Ombudsman, and the Department at least: (a) 30 days before any proposed transfer or discharge if the nursing facility is not part of a continuing care retirement community as defined in Article 70B, Annotated Code of Maryland; or (b) 60 days before any proposed transfer or discharge if the nursing facility is part of a continuing care retirement community."

As soon as possible for an emergency transfer — 10.07.09.10C(2): "In an emergency situation, a nursing facility shall notify the resident, representative, or interested family member of a transfer as soon as possible."

Forty-eight hours before an involuntary move — COMAR 10.07.09.11A: a facility may not involuntarily discharge or transfer a resident "unless, within 48 hours before the discharge or transfer," it has provided or obtained a comprehensive medical assessment, a post-discharge plan of care, and the attending physician's written documentation, and has provided information about the resident's health-care decision rights.

Thirty days to request the hearing — COMAR 10.07.09.13A and 13C(1), quoted in full above.

Thirty-day resident-tenure exception — COMAR 10.07.09.13B: the pendency protection applies "Except in an emergency or when the resident has resided in a facility for less than 30 days," quoted in full above.

Thirty-day advance notice of an in-facility relocation — COMAR 10.07.09.12A(1): "Except in emergency situations or when it is documented in the resident's record that a resident's physical, clinical, or psychological well-being would be jeopardized, a nursing facility shall notify a resident or, when applicable, the resident's representative or interested family member, if available, in writing at least 30 days before the resident is relocated within a facility or to a different part of a facility, unless the resident or, if the resident is incapacitated, the resident's legally authorized representative, agrees to the relocation and this is documented in the resident's record."

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

Source map

Captured: all six, in tools/packets/maryland-packet.txt (recipe tools/recipes/maryland.json, digest 094cd75387b1). Pending: the Department's prescribed notice form itself (Regulation .10D describes its required contents but no specimen or online copy was located), a street address, telephone number or filing portal for the Office of Administrative Hearings, a specific reserved-bed-day count under the State Medicaid plan (COMAR 10.07.09.12D names the Medicaid plan as the source of the bed-hold period but does not state it, and the Medicaid nursing-facility chapter, COMAR Title 10, Subtitle 09, Chapter 10, states no reserved-bed provision in its chapter index or its Regulation .01 definitions), and a statewide ombudsman telephone number (the Department of Aging's page publishes none).

Change log

2026-09-16 — Deepened to a full page. Recaptured all six sources through the existing recipe (tools/recipes/maryland.json, digest 094cd75387b1, unchanged from the 2026-09-13 recipe backfill; transport curl throughout, with source 1 now reachable by plain curl with a browser user-agent where the 2026-08-30 capture had needed the session's fetch tool). No new sources were added: the standing packet already carried Regulations .11, .12 and .13 in full, which the baseline page had captured but not yet quoted, so section 01 and section 02 are built entirely from the existing packet. Wrote section 01 (the grounds, in the statute's and the regulation's own order) and section 02 (requesting the hearing, the notice's required contents in full, bed-hold and return, and the notice-periods register). Findings, continuing the baseline page's numbering: (1) the statute's five grounds and the regulation's five are the same list except that the regulation adds decertification or withdrawal from Medicare or Medicaid to the facility-ceases-to-operate ground; both stand as published, reconciled nowhere. (2) The regulation directs the hearing request to the Office of Administrative Hearings by the thirtieth calendar day after receipt but publishes no address, form or telephone number for that office, and no first-party page from it was captured; the absence is stated rather than filled. (3) Maryland states that a hearing under this regulation "is not a contested case as defined in the Administrative Procedure Act" and that the parties are the facility and the resident, with the Department not a party. (4) The Department of Aging's ombudsman page publishes no statewide program telephone number, while the regulation requires the facility's own notice to carry the state and local ombudsman contacts; the ombudsman row states what each publisher publishes. (5) COMAR 10.07.09.12D names "the bed-hold period under the State Medicaid plan" as the readmission trigger but does not itself state a number of days; a search of the Medicaid nursing-facility chapter's index and definitions (COMAR 10.09.10) located no reserved-bed-day provision, so that absence is stated rather than filled from another source. (6) Regulation .11 requires a comprehensive medical assessment, a post-discharge plan of care and the attending physician's written documentation within 48 hours before an involuntary move, and requires the facility to provide a written medication list, at least a three-day medication supply, and a written statement of the discharge's date, time, method, mode and destination at the time of transfer — none of which was quoted on the baseline page. Capture pending: per the source map. Internet Archive: not yet submitted for this pass. Reviewer: Carrie Schluter, reviewed 2026-09-16. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Maryland packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Maryland 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) Maryland publishes two notice periods, thirty days and sixty days for a facility that is part of a continuing care retirement community, and both are quoted as published. (2) The statute's five grounds and the regulation's five are the same list except that the regulation adds decertification or withdrawal from Medicare or Medicaid to the facility-ceases-to-operate ground; both stand as published, reconciled nowhere. (3) The regulation directs the hearing request to the Office of Administrative Hearings by the thirtieth calendar day after receipt but publishes no address, form or telephone number for that office, and no first-party page from it was captured; the absence is stated rather than filled. (4) Maryland states that a hearing under this regulation "is not a contested case as defined in the Administrative Procedure Act" and that the parties are the facility and the resident, with the Department not a party — a shape none of the states built so far shares. (5) The Department of Aging's ombudsman page publishes no statewide program telephone number on the page captured, while the regulation requires the facility's own notice to carry the state and local ombudsman contacts; the ombudsman row states what each publisher publishes. (6) The General Assembly's statute site renders text only to a scripted client and returned no statute text to curl; § 19-345 was captured through the session's fetch tool. (7) Regulation .12, captured in this packet, covers relocation within a facility and bed hold and will be quoted in section 02 when that section is written. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.