Michigan

The grounds, as Michigan describes them

The department's 2013 guidance (LARA (PDF), September 12, 2013, retrieved 2026-09-13) reproduces the statute it is written to explain: "Sec. 21773.(1) A nursing home shall not involuntarily transfer or discharge a patient" "except for one or more of the following purposes:", in the statute's own order:

"Medical reasons."

"The patient's welfare."

"The welfare of other patients or nursing home employees."

"Nonpayment for the patient's stay, except as prohibited by title XIX of" "the Social Security Act, Chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to" "1396r-6 and 1396r-8 to 1396v."

The department's current prescribed notice, LARA-BCHS-ITD-100 (07/26/2024), requires a facility to check a reason from this state list and, separately, a reason from the federal enumeration at 42 CFR 483.15(c)(1), under the instruction "Reason(s) for transfer or discharge, both a state and federal must be selected." The form's own state-column labels are "Medical reasons", "Welfare of the resident", "Welfare of other residents and staff" and "Nonpayment of resident stay" — a plain-language shortening of the statute's four purposes rather than a verbatim reprint; both are shown as published. The federal enumeration stays on the federal page.

The published process

Requesting the hearing

The notice form states: "If the resident thinks that they should not have to leave, a resident may file a request for a" "hearing with the Department of Licensing and Regulatory Affairs (LARA)." "The appeal request must be received by LARA within 10 days of the date of notice." "If the resident, guardian, or resident representative requests a hearing, it will be held at least" "7 days after the request, and the resident will not be transferred during that time." The pendency statement, as the 2013 guidance reproduces the statute: "A request for a hearing made under subsection (3) shall stay a transfer" "pending a hearing or appeal decision."

The route the form publishes: "Mail" to "Michigan Department of Licensing and Regulatory Affairs" "Bureau of Community and Health Systems" "P.O. Box 30664" "Lansing, MI 48909", "Email" to "LARA-BCHS-InvoluntaryTransfer@michigan.gov", or "Fax" to "517-763-0213". The form attaches its own appeal-request page (page 5 of 7) and states the facility "shall provide a postage paid envelope addressed or" "assistance with electronic submission of the form to LARA."

Once a hearing is requested, a different unit conducts it: "An appeal hearing will be conducted by the Michigan Office of Administrative Hearings and Rules" "(MOAHR) in accordance with the Michigan Administrative Code, R 792.10101-R 792.11289 and" "Administrative Procedures Act (APA), MCL 24.201 et seq." The form's own hearing guidance states that "The resident may speak for themself and may be represented by an attorney, a relative, or another" "person of choice by the resident", that proposed exhibits "must be filed and" "exchanged with other parties a minimum of 3 business days before hearing, unless the ALJ orders" "a different timeframe", and that "Within 7 days after service of a default order, a person" "may file a written motion requesting that the order be vacated for good cause".

The notice's required contents

The 2013 guidance's reproduction of subsection (3): the notice "shall be on a form prescribed by the" "Michigan Department of Licensing and Regulatory Affairs and shall contain all" "of the following:" "The stated reason for the proposed transfer."; "The effective date of the proposed transfer."; a statement "in not less than 12-point type that reads:" the appeal right in full — "You have a right" "to appeal the nursing home's decision to transfer you. If you think you" "should not have to leave this facility, you may file a request for a hearing" "with the Michigan Department of Licensing and Regulatory Affairs within" "10 days after receiving this notice. If you request a hearing, it will be" "held at least seven (7) days after your request, and you will not be" "transferred during that time. If you lose the hearing, you will not be" "transferred until at least 30 days after you received the original notice of" "the discharge or transfer."; "A hearing request form, together with a postage paid, preaddressed" "envelope to the Michigan Department of Licensing and Regulatory" "Affairs."; "The name, address, and telephone number of the responsible official in" "the Michigan Department of Licensing and Regulatory Affairs."; "The location to which the resident is transferred or discharged."; and "The name, address and telephone number of the State long term care" "ombudsman."

The 2024 form itself is organized differently and adds fields the 2013 guidance does not describe — a guardian/representative-service confirmation, a Medicaid level-of-care-determination question, and the requirement that a facility select both a state and a federal reason. It states plainly that "The Notice form will be accepted by the department only if all informational boxes have been" "completed, including a proposed transfer or discharge location, date, and specific information" "about the reasons for transfer or discharge." Both documents are shown as published; neither is treated as superseding the other's account of what the notice must contain.

Bed-hold and return

No captured Michigan source states a bed-hold rule inside the transfer-and-discharge statute or the notice form itself; the department's Medicaid provider bulletins address it separately, as a payment question. Long Term Care Facilities 00-05 (issued January 1, 2001, effective December 1, 2000): "Effective January 1, 2001, Medicaid will reimburse a nursing facility during a Medicaid resident's" "temporary absence from the facility for admission to the hospital for emergency medical" "treatment. If there is a reasonable expectation by the attending physician at the point of" "admission that the resident will return from the hospital by the end of the tenth day, the nursing" "facility shall hold the bed." The same bulletin, on therapeutic leave: "Effective with the date of this bulletin, Medicaid will reimburse a nursing facility for 18" "therapeutic leave days during a 365day period. If the resident has a temporary absence from" "the nursing facility for therapeutic reasons as approved by a physician, the facility shall hold the" "bed open for up to a total of 18 days during a 365day period."

Bulletin MSA 04-20 (issued December 1, 2004, effective January 1, 2005) amends the hospital-leave rule to add an occupancy condition: "For Hospital Leave Days, Medicaid will pay to hold a beneficiary’s bed only when the facility’s total" "available bed occupancy is at 98 percent or more on the day the beneficiary leaves the facility." "Facilities at 97.5 percent occupancy may round up to 98 percent." The bulletin states this "change is effective for dates of service on and after January 1, 2005" and that "Except as explained above, Medicaid’s policy on hospital leave days, as outlined in the Nursing Facilities Coverages and Limitations" "Chapter, remains unchanged" — so the ten-day hold from the 2001 bulletin stands, now conditioned on the facility's occupancy that day. On return, MSA 04-20 states: "Facilities are reminded that beneficiaries must be readmitted immediately to the first available bed if the" "beneficiary still requires nursing home services and is still Medicaid eligible." No more current statement of these leave-day rules was located on michigan.gov, whose Medicaid Provider Manual is served as a document library this project's bounded transports could not fetch by chapter; both bulletins are quoted as the newest version located from this publisher.

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Michigan'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 — the guidance's reproduction of subsection (2): "A licensed nursing home shall provide written notice at least 30 days before a" "patient is involuntarily transferred or discharged."

Exceptions to the 30-day requirement — subsection (2)(a)-(c): an emergency transfer "mandated by the patient's health care needs", a transfer "mandated by the physical safety of other" "patients and nursing home employees", or a transfer "subsequently agreed to by the patient or" "the patient's legal guardian".

Ten days to request a hearing — the notice's own appeal-rights statement, quoted above in full; the form separately states "The appeal request must be received by LARA within 10 days of the date of notice."

At least seven days to the hearing — the appeal-rights statement: a hearing "will be" "held at least seven (7) days after your request, and you will not be" "transferred during that time"; the 2024 form states the same period as "at least" "7 days after the request".

Thirty days after the original notice if the hearing is lost — the appeal-rights statement: "If you lose the hearing, you will not be" "transferred until at least 30 days after you received the original notice of" "the discharge or transfer."

The 34th day or the 10th day after decision, whichever is later — the 2024 form's own timeline, stated differently from the 2013 guidance's appeal-rights paragraph above: "If LARA determines that a transfer or discharge is authorized, the resident shall not be" "required to transfer or discharge from the facility before the 34th day following receipt of the" "notice or the 10th day following appeal hearing decision, whichever is later." Both stand as published, reconciled nowhere.

Three business days for hearing exhibits — the hearing guidance: exhibits "must be filed and" "exchanged with other parties a minimum of 3 business days before hearing, unless the ALJ orders" "a different timeframe."

Seven days to move to vacate a default order — the hearing guidance: "Within 7 days after service of a default order, a person" "may file a written motion requesting that the order be vacated for good cause".

Ten-day and eighteen-day Medicaid leave-day limits — quoted in full above under Bed-hold and return: a ten-day hospital-leave hold conditioned since 2005 on 98 percent facility occupancy, and an eighteen-day therapeutic-leave allowance "during a 365day period."

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/michigan-packet.txt. Pending: MCL 333.21773 from the Legislature's own site, the department's transfer and discharge overview page, a statewide contact from the ombudsman program's own site, and a current (post-2005) statement of the leave-day rules if the department's provider manual becomes reachable by a bounded transport — per the packet's pending list.

Change log

2026-09-13 — Deepened to a full page. Newly captured: two Medicaid provider bulletins on leave-day reimbursement, MSA 04-20 (2004, sources 3) and Long Term Care Facilities 00-05 (2001, source 4), both one-off PDF bulletins fetched by curl with a browser user-agent and pdftotext -layout, matching this recipe's existing transport; neither required slicing. The recipe's two standing sources were recaptured in the same pass (tools/recipes/michigan.json, digest 508f3660fd67) and promoted as a rebuild; no content change was found in either. 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: (8) Michigan's Medicaid bed-hold rules live entirely outside the transfer-and-discharge statute and the notice form, in two provider bulletins: a 2001 bulletin sets a ten-day hospital-leave hold and an eighteen-day therapeutic-leave allowance, and a 2004 bulletin amends the hospital-leave hold to require the facility be at 98 percent occupancy (97.5 percent rounding up) on the day the resident leaves, leaving the ten-day figure and the therapeutic-leave figure otherwise unchanged. No later restatement of either rule was located: michigan.gov's current Medicaid Provider Manual is served as a document library rather than an address this project's bounded transports could fetch by chapter, so both bulletins are quoted as the newest version located from this publisher. (9) The notice's own post-hearing timeline (the 34th day after notice, or the 10th day after a hearing decision, whichever is later — LARA-BCHS-ITD-100, 2024) differs from the 2013 guidance's appeal-rights paragraph ("you will not be transferred until at least 30 days after you received the original notice"); both are quoted as published, a continuation of finding (2) below rather than a new discrepancy. (10) The hearing itself, once requested, is conducted by a separate unit from the one that receives the request: LARA receives and processes the appeal, but the Michigan Office of Administrative Hearings and Rules (MOAHR) conducts it under its own administrative code and the state Administrative Procedures Act — a structural fact the notice form states but the statute and the 2013 guidance do not. Capture pending: per the source map. Internet Archive: not yet submitted for the two new sources. Reviewer: Carrie Schluter, reviewed 2026-09-15. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Michigan packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Michigan 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 statute could not be captured from its own publisher: legislature.mi.gov serves an incomplete certificate chain to curl and returned an empty body to the session's fetch tool for both the section page and the Part 217 PDF, so this page quotes the department's reproduction of MCL 333.21773 inside its guidance and says so. (2) The department's two documents state the post-hearing timeline differently. The 2013 guidance's reproduction of the statute reads "If you lose the hearing, you will not be" "transferred until at least 30 days after you received the original notice of" "the discharge or transfer."; the 2024 form states "the resident shall not be" "required to transfer or discharge from the facility before the 34th day following receipt of the" "notice or the 10th day following appeal hearing decision, whichever is later." Both stand as published, reconciled nowhere. (3) The guidance's reproduction of subsection (6) refers to "the 21-day written notice period of subsection (2)" where subsection (2) states 30 days; the mismatch is the publisher's own and is reproduced as published. (4) The guidance substitutes the department's current name inside the quoted statute — including in subsection (6), where the negative action described is a Medicaid determination — while the notice form asks separately whether "a final determination been issued by the Michigan Department" "of Health and Human Services (MDHHS)". Both stand as published. (5) The form requires a facility to select both a state and a federal reason for the same transfer or discharge, from two lists that do not match item for item; the state list is quoted here, and the federal enumeration stays on the federal page. (6) The ombudsman program's own site publishes a county-by-county picker rather than a statewide contact on the page captured, so the ombudsman row carries the contact the department prints on the notice form; the program's own published contact is capture-pending. (7) Neither source states a Michigan Medicaid bed-hold period. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.