Massachusetts
- Grounds stated in the sources
- 130 CMR 456.701(A): "A resident may be transferred or discharged from a nursing facility only when" — "the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the nursing facility;"; "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 nursing facility;"; "the safety of individuals in the nursing facility is endangered;"; "the health of individuals in the nursing facility would otherwise be endangered;"; "the resident has failed, after reasonable and appropriate notice, to pay for (or failed to have MassHealth or Medicare pay for) a stay at the nursing facility; or"; "the nursing facility ceases to operate." The regulation also names a sixth situation that counts as a move: "A nursing facility’s failure to readmit a resident following a medical leave of absence will be deemed a transfer or discharge (depending on the resident’s circumstances)."
- Notice stated in the sources
- 130 CMR 456.702(A): "The notice of discharge or transfer required under 130 CMR 456.701(C) must be made by the nursing facility at least 30 days prior to the date the resident is to be discharged or transferred", except in four stated circumstances where it "must be made as soon as practicable". On delivery and contents, 456.701(C): "Before a nursing facility discharges or transfers any resident, the nursing facility must hand" "deliver to the resident and mail to the authorized or legal representative a notice written in 12-" "point or larger type that contains, in a language the member understands, the following:" — ten items, among them "a statement informing the resident of their right to request a hearing before MassHealth’s Board of Hearings, including" "the address to send a request for a hearing;", the local ombudsman's contact, a statement that free legal assistance may be available with the address of the nearest legal services office, and "the name of a person at the nursing facility who can answer any questions the resident has about the notice and who will be available to assist the resident in filing an appeal."
- Hearing office in these sources
- MassHealth's Board of Hearings: "Appeals of discharges and transfers will be handled by MassHealth’s Board of Hearings" "(BOH) pursuant to 130 CMR 610.000: MassHealth: Fair Hearing Rules." The deadlines run from the kind of notice: "30 days after a resident receives written notice of a discharge or transfer pursuant to 130 CMR 456.702(A);" or "14 days after a resident receives written notice of an emergency discharge or emergency transfer pursuant to 130 CMR 456.702(B); or" fourteen days where the move follows a failure to readmit. On pendency: where the request arrives during the notice period, "the nursing facility must stay the planned discharge or transfer until 30 days after the decision is rendered." MassHealth publishes the Board's routes on its appeals page — by mail or in person at "Office of Medicaid, Board of Hearings" "1 Enterprise Drive, 3rd Floor" "Quincy, MA 02171", by fax to "1-617-887-8797", by email to boh-fairhearingsrequest@mass.gov — while the same page's contact block gives a different mailing address, "100 Hancock Street, 6th Floor, Quincy, MA 02171". Both are shown as published.
- Ombudsman in these sources
- The Long-Term Care Ombudsman, in the Executive Office of Aging & Independence. The Commonwealth publishes "Long-Term Care Ombudsman and Assisted Living Ombudsman: 617-222-7495" and a general program line, "Contact an Ombudsman Program: (617) 727-7750/711 MassRelay/TTY", with the office at "One Ashburton Place, 10th floor, Boston, MA 02108" and MassOptions at "800-243-4636". The regulation requires the facility's own notice to carry "the name, address, and telephone number of the local long-term-care ombudsman office;".
- Sources last checked
- Oct 3, 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 Massachusetts's own publishers state about transfer and discharge from a nursing facility. The fullest single source is 130 CMR 456.000, the Nursing Facility Manual, whose sections 456.701 through 456.705 state the grounds, the thirty-day notice and its exceptions, the notice's ten required contents, the appeal deadlines, the stay pending appeal and the scheduling of the hearing, and whose sections 456.425 through 456.433 state the MassHealth bed-hold payment policy for a hospital stay or a home visit. Massachusetts's vocabulary is transfer or discharge; the appeal is a fair hearing before MassHealth's Board of Hearings.
Two features are worth naming for a reader. Massachusetts runs two appeal clocks — thirty days for an ordinary notice, fourteen for an emergency move or a refusal to readmit — and it requires the facility's own notice to name a person at the facility "who will be available to assist the resident in filing an appeal." 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 Massachusetts describes them
130 CMR 456.701(A) (MassHealth (PDF), regulation page date 09/08/2025, Transmittal Letter NF-64, retrieved 2026-09-14): "A resident may be transferred or discharged from a nursing facility only when (1) the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the nursing 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 nursing facility; (3) the safety of individuals in the nursing facility is endangered; (4) the health of individuals in the nursing facility would otherwise be endangered; (5) the resident has failed, after reasonable and appropriate notice, to pay for (or failed to have MassHealth or Medicare pay for) a stay at the nursing facility; or (6) the nursing facility ceases to operate."
Subsection (D) names a sixth situation that counts as the same thing: "A nursing facility’s failure to readmit a resident following a medical leave of absence will be deemed a transfer or discharge (depending on the resident’s circumstances)."
The published process
Requesting the hearing
130 CMR 456.703(A): "Appeals of discharges and transfers will be handled by MassHealth’s Board of Hearings (BOH) pursuant to 130 CMR 610.000: MassHealth: Fair Hearing Rules." Subsection (B): "The date of request for a fair hearing is the date on which BOH receives such a request in writing. BOH must receive the request for a fair hearing within the following time limits:" "30 days after a resident receives written notice of a discharge or transfer pursuant to 130 CMR 456.702(A); or (2) 30 days after a nursing facility initiates a transfer or discharge or fails to readmit and fails to give the resident notice; or (3) 14 days after a resident receives written notice of an emergency discharge or emergency transfer pursuant to 130 CMR 456.702(B); or (4) 14 days after a resident receives written notice of a transfer or discharge that is the result of a nursing facility’s failure to readmit a resident following hospitalization or other medical leave of absence."
The regulation itself states no filing address; MassHealth's general appeals page, "How to appeal a MassHealth decision", publishes the Board's routes — by mail or in person at "Office of Medicaid, Board of Hearings" "1 Enterprise Drive, 3rd Floor" "Quincy, MA 02171", by fax to "1-617-887-8797", by email to boh-fairhearingsrequest@mass.gov — while the same page's own contact block gives a different mailing address, "100 Hancock Street, 6th Floor, Quincy, MA 02171". Both are shown here as published, reconciled nowhere.
On pendency, 130 CMR 456.704: "If a request for a hearing regarding a discharge or transfer from a nursing facility is received by the Board of Hearings during the notice period described in 130 CMR 456.703(B)(1), the nursing facility must stay the planned discharge or transfer until 30 days after the decision is rendered. While this stay is in effect, the resident must not be transferred or discharged from the nursing facility." Subsection (B), for an emergency notice: "If a hearing is requested, in accordance with 130 CMR 456.703(B)(2), and the request is received prior to the discharge or transfer, then the nursing facility must stay the planned transfer or discharge until five days after the hearing decision." Subsection (C), if the resident is moved before the hearing is decided: "If the request for a hearing, in accordance with 130 CMR 456.703(B)(2), is received within the applicable time frame but after the transfer, the nursing facility must, upon receipt of an appeal decision favorable to the resident, promptly readmit the resident to the next available bed in the facility."
The notice's required contents
130 CMR 456.701(C): "Before a nursing facility discharges or transfers any resident, the nursing facility must hand deliver to the resident and mail to the authorized or legal representative a notice written in 12-" "point or larger type that contains, in a language the member understands, the following:"
"(1) the action to be taken by the nursing facility;"
"(2) the specific reason or reasons for the discharge or transfer;"
"(3) the effective date of the discharge or transfer;"
"(4) the location to which the resident is to be discharged or transferred;"
"(5) a statement informing the resident of their right to request a hearing before MassHealth’s Board of Hearings, including (a) the address to send a request for a hearing; (b) the time frame for requesting a hearing as provided for under 130 CMR 456.702; and (c) the effect of requesting a hearing as provided for under 130 CMR 456.704;"
"(6) the name, address, and telephone number of the local long-term-care ombudsman office;"
"(7) for nursing facility residents with developmental disabilities, the address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled individuals established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. s. 6041 et seq.);"
"(8) 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 established under the Protection and Advocacy for Mentally Ill Individuals Act (42 U.S.C. s. 10801 et seq.);"
"(9) a statement that all residents may seek legal assistance and that free legal assistance may be available through their local legal services office. The notice should contain the address of the nearest legal services office; and"
"(10) the name of a person at the nursing facility who can answer any questions the resident has about the notice and who will be available to assist the resident in filing an appeal."
Bed-hold and return
130 CMR 456.425 states the payment side directly: "MassHealth pays a nursing facility to reserve a bed for up to 20 consecutive days for a member who is on a medical leave of absence from the nursing facility, if all the conditions of 130 CMR 456.426 and 456.427 are met." Subsection (B) requires a facility's own written policy: "In accordance with federal law, nursing facilities must establish and follow a written policy regarding their bed-hold periods, which must be consistent with the MassHealth bed-" "hold policy." Subsection (C), the ordinary return: "Following a medical leave of absence of 20 days or fewer, the nursing facility must allow the member to return to the nursing facility and resume residence unless the member no longer requires the services provided by the nursing facility." Subsection (D), where the stay runs longer: "When a member’s hospitalization exceeds 20 days or does not meet the requirements of 130 CMR 456.426, the nursing facility must immediately readmit the member to the facility, to the next available bed in a semiprivate room, unless the member no longer requires the services provided by the nursing facility."
A separate, shorter allowance covers an absence that is not medical. 130 CMR 456.430: "MassHealth will pay the nursing facility to reserve a bed for a member when the member is temporarily absent from the facility for nonmedical reasons". 130 CMR 456.431: "MassHealth pays for temporary absences for nonmedical leave for members in nursing facilities for up to a total of ten days per 12-month period starting with the first day of the nonmedical leave."
The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Massachusetts'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 — 130 CMR 456.702(A): "The notice of discharge or transfer required under 130 CMR 456.701(C) must be made by the nursing facility at least 30 days prior to the date the resident is to be discharged or transferred", except as provided under subsection (B).
As-soon-as-practicable exceptions — subsection (B): "the notice of discharge or transfer required under 130 CMR 456.701(C) must be made as soon as practicable" in four stated circumstances, among them that "The resident has not resided in the nursing facility for 30 days immediately prior to receipt of the notice."
Thirty or fourteen days to request a fair hearing — 130 CMR 456.703(B), quoted above in full.
Thirty days' stay after an ordinary notice, five days' stay after an emergency notice — 130 CMR 456.704(A) and (B), quoted above in full.
Twenty consecutive days for a MassHealth medical-leave bed-hold, ten days per twelve months for a nonmedical leave — 130 CMR 456.425(A) and 456.431, quoted above in full.
What any of these periods means for a particular case is for the hearing office to determine.
Source map
| Document | Publisher and location | Source's own date | Retrieved |
|---|---|---|---|
| 130 CMR 456.701—456.705, transfers and discharges (excerpt from the posted Nursing Facility Manual PDF) | MassHealth | regulation page 09/08/2025; Transmittal Letter NF-64, 09/08/25 | 2026-08-30 |
| 130 CMR 456.425—456.433, Medical and Nonmedical Leave of Absence (excerpt from the same Nursing Facility Manual PDF) | MassHealth | regulation page 09/08/2025; Transmittal Letter NF-64, 09/08/25 | 2026-09-14 |
| Notice of Nursing Facility Residents' Rights, LTC-013 (PDF) | Division of Medical Assistance | LTC-013 (Rev. 01/01) | 2026-08-30 |
| How to appeal a MassHealth decision | MassHealth, Office of Medicaid Board of Hearings | none stated on page | 2026-08-30 |
| Talk to an Ombudsman about a problem | Executive Office of Aging & Independence | none stated on page | 2026-08-30 |
Captured: all five, in tools/packets/massachusetts-packet.txt, tools/packets/massachusetts-packet-regs.txt and tools/packets/massachusetts-packet-bedhold.txt. Pending: 130 CMR 610.000 and the address a hearing request is sent to — per the packets' pending lists.
Change log
2026-09-14 — Deepened to a full page. Newly captured: 130 CMR 456.425 through 456.433 (source 1 of a new supplemental packet, tools/packets/massachusetts-packet-bedhold.txt), the MassHealth bed-hold and leave-of-absence provisions the two standing packets recorded as uncaptured. mass.gov still refuses both curl and the WebFetch tool for this document (confirmed again this pass); the capture was taken with the built-in browser tool by opening the regulation's listing page (which does load) and running an in-page fetch() against the same PDF the standing packet already quotes from 456.701 through 456.705, then decoding the result outside the browser — the identical document, a different section of it. No capture.py recipe exists for Massachusetts, per the standing packets' own notes that every mass.gov transport tried is blocked; this remains a hand capture, marked not automatically re-verifiable, per PROVENANCE.md's rule for browser-mediated captures. Section 01 (the grounds) 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.
Findings, continuing the numbering from 2026-08-30: (9) MassHealth's bed-hold policy runs two separate clocks that answer two different absences: up to 20 consecutive days for a medical leave of absence (a hospital stay), and up to 10 days per 12-month period for a nonmedical leave of absence (a home visit) — the state's own vocabulary distinguishes MLOA from NMLOA, and this page preserves that distinction rather than treating "bed-hold" as one undifferentiated period. (10) The regulation requires a facility to keep its own written bed-hold policy "consistent with the MassHealth bed-hold policy" but does not itself state what a facility's policy must say beyond that; no further first-party statement was found. (11) 130 CMR 456.434 through 456.450 are reserved in the Commonwealth's own document — a deliberate gap in the numbering, not a missed capture. (12) 130 CMR 610.000, the fair hearing rules 456.703(A) makes governing, remains uncaptured, as does a published address for filing a hearing request. Capture pending: per the source map. Internet Archive: not yet submitted for the new source. Reviewer: Carrie Schluter, reviewed 2026-09-15. Corrections: hello@fieldassembly.net.
2026-08-30 — Baseline page built from the first Massachusetts packet, then rebuilt the same day from a supplemental packet carrying the regulation. Not yet captured or written: section 01 (the grounds, as Massachusetts 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) The first packet recorded 130 CMR 456.000 as capture-blocked, and the grounds row and notice period stood as absences. Both are now captured. mass.gov still refuses curl, and the regulation page itself carries no rule text — only metadata and download links — so the capture is the PDF the Commonwealth posts there, taken through the session's fetch tool and sliced to 456.701 through 456.705. (2) The Commonwealth labels its own posted copy: "This is an unofficial version of Commonwealth regulations and is posted here for the convenience of the public. It is not an official statement of the regulations." — naming the Massachusetts Register as the official version. The packet records that statement, and this page quotes the copy the Commonwealth publishes, described as the Commonwealth describes it. (3) Massachusetts runs two appeal clocks: thirty days from an ordinary notice, fourteen from an emergency discharge or transfer, and fourteen where the move is a facility's failure to readmit after hospitalization or medical leave. All are quoted as published. (4) A failure to readmit after a medical leave of absence is deemed a transfer or discharge, which brings the notice and appeal machinery with it. (5) The regulation requires the facility's notice to state "the address to send a request for a hearing" and does not itself state one; MassHealth's general appeals page gives two different addresses for the Board of Hearings, and both remain on this page as published. (6) The regulation requires the notice to name a person at the facility available to assist the resident in filing the appeal, and to state that free legal assistance may be available with the address of the nearest legal services office. (7) 130 CMR 610.000, the fair hearing rules the regulation makes governing, is still uncaptured, as is any MassHealth bed-hold period. (8) The residents' rights summary in the first packet, LTC-013, still carries a revision line of 01/01 and is quoted only for the rights it states. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.