Mississippi

The grounds, as Mississippi describes them

Mississippi's two captured publishers do not state grounds the way the federal regulation enumerates them, and neither states a list addressed to the facility as a rule of general application.

The health department's licensure standard, Rule 45.17.2, Residents' Rights (Chapter 45, Minimum Standards for Institutions for the Aged or Infirm), states it as the fourth of the residents' rights the facility's policies must ensure: the resident "Is transferred or discharged only for medical reasons, or for his welfare or that of other residents, or for nonpayment for his stay (except as prohibited by sources of third-party payment)" (Rule 45.17.2(4)).

The Division of Medicaid's Rule 2.20, Facility Initiated Discharges (Title 23 Part 207, Institutional Long Term Care Services, effective 8.1.26), states no counterpart list. What it states instead are the four circumstances under which the standard thirty-day notice period may be shortened, in the rule's own order: "The safety or health of the individuals in the nursing facility would be endangered," "The resident no longer requires the level of care provided by the nursing facility," "An immediate transfer or discharge is required by the resident's urgent medical needs, or" and "The resident has not resided in the nursing facility for thirty (30) calendar days." (Rule 2.20.A.1.a-d). These are drafted as exceptions to a notice period, not as an independent statement of permissible grounds for a facility-initiated discharge, and this page does not read them as one.

No captured Mississippi source enumerates permissible grounds the way the federal floor does. That absence is stated here rather than filled from federal regulation or another state's rule; the federal floor is assembled separately on the federal page.

The published process

Requesting the hearing

Two rules touch this from different directions, and neither cites the other. Rule 2.20 requires the discharge notice itself to state "A statement that the resident has the right to appeal the action to the appropriate state" "authorities," without naming one. Title 23 Part 300 (Appeals), the Division of Medicaid's general fair-hearing rule, names the category directly: "Beneficiaries who are subject to a proposed transfer or discharge from a long-term care" "facility or nursing facility," are one of six groups with "appeal processes through the Division of Medicaid" (Rule 2.3.A.4). This page treats Part 300 as the route Rule 2.20's own line points toward, on the strength of Rule 2.3.A.4 alone; the connection is this page's, not either publisher's own cross-reference.

Part 300 states a four-level process — "Grievance," "Local Hearing," "State Hearing, also referred to as Fair Hearing, and" "Judicial Review." (Rule 2.3.B) — and states that "All hearing requests may initially be written, oral, or made in-person at a regional office." (Rule 2.7.A). A written request "may be mailed to the regional office or central office." and, separately, "If the hearing involves an issue that requires that a state hearing be held or if a state hearing is requested, the request will be forwarded to the Office of Administrative Appeals." (Rule 2.7.B.2-3). No street address, phone number, or filing form for the regional office, the central office, or the Office of Administrative Appeals is stated in Part 300 as captured.

The filing period: "The applicant or beneficiary has thirty (30) days from the postmark date of the appropriate notice to request either a local or state hearing." (Rule 2.8.A), extendable "if the applicant or beneficiary can show good cause, as determined by the Division of Medicaid, for not filing within thirty (30) days." (Rule 2.8.A). Rule 2.6.B states the same period from a different anchor: the beneficiary "must request a hearing within thirty (30) days of the notice of adverse action." (Rule 2.6.B).

Pendency: "When an applicant/beneficiary or representative requests a hearing within the Advance Notice Period, benefits must be continued or reinstated to the benefit level in effect prior to the planned adverse action, if a timely request is filed." (Rule 2.21). A request is timely for this purpose only if "the request must be received by the regional office within ten (10) days from the notice date of the adverse action." (Rule 2.21.A.1) — a shorter window than the thirty days allowed to request a hearing at all. Rule 2.21 is written for Medicaid "benefits" generally and never uses the words "discharge" or "transfer"; whether it reaches continued residence at the nursing facility during a Rule 2.20 appeal is not stated in the sources reviewed.

The notice's required contents

Rule 2.20.A.2: the notice "must be written, easily understood and include the following information:" "The reason for the transfer or discharge," "The effective date of the transfer or discharge," "The location to which the resident is being transferred or discharged," "A statement that the resident has the right to appeal the action to the appropriate state" "authorities," "The name, address and telephone number of the State long-term care ombudsman," "For residents with developmental disabilities, the mailing address and telephone" "number of the agency responsible for the protection and advocacy of developmentally" "disabled individuals, and" "For residents with mental illness, the mailing address and telephone" "number of the agency responsible for the protection and advocacy of mentally ill individuals." (Rule 2.20.A.2.a-g). The licensure standard, Rule 45.17.2(4), states none of these contents; only the Medicaid rule speaks to what the notice must contain.

Bed-hold and return

The Division of Medicaid's Rule 2.8, Temporary Leave (Title 23 Part 207), is Mississippi's captured bed-hold provision; the licensure standard states none. Before a leave begins, "the nursing facility must provide a written notice to the resident and/or family member or legal" "representative explaining the nursing facility's temporary leave, bed-hold and resident return" "policies," (Rule 2.8.B) which "must define the period of time during which the resident is permitted" "to return and resume residence in the nursing facility" (Rule 2.8.B.1) and "must also state that if the resident's absence exceeds the Division of" "Medicaid's bed-hold limit the resident will be readmitted to the nursing facility upon the" "first availability of a semi-private bed if the resident still requires the services provided" "by the nursing facility." (Rule 2.8.B.2).

Mississippi Medicaid covers two kinds of temporary leave, on different limits. Home or therapeutic leave: "up to fifteen (15) consecutive days of home/therapeutic" "temporary leave per one (1) absence for up to a total of forty-two (42) days per state fiscal" "year" (Rule 2.8.C). "The nursing facility must reserve the resident's bed in anticipation of the resident's return" "and cannot fill the resident's bed with another resident during the covered period of" "home/therapeutic temporary leave." (Rule 2.8.C.4), and "Nursing facilities cannot refuse to readmit a resident from home/therapeutic temporary" "leave if the facility has billed for home/therapeutic leave days and the resident still" "requires the services provided by the nursing facility." (Rule 2.8.C.5).

Inpatient hospital leave: "fifteen (15) consecutive days of inpatient hospital" "temporary leave per each absence for continuous acute care during an inpatient hospital stay." (Rule 2.8.D), with "no maximum number of inpatient hospital temporary leave days per each state" "fiscal year." (Rule 2.8.D.2). The same bed-reservation duty applies — "The nursing facility must reserve the resident's bed in anticipation of the resident's return" "and cannot fill the resident's bed with another resident during the covered period of" "inpatient hospital temporary leave." (Rule 2.8.D.8) — as does a readmission-refusal bar worded slightly differently than the home-leave version: "Nursing facilities cannot refuse to readmit a resident from inpatient hospital temporary" "leave if the facility has billed for inpatient hospital leave days and still" "requires the services provided by the nursing facility." (Rule 2.8.D.7). A resident who "remained in the inpatient hospital receiving acute care and" "returns to any Medicaid certified nursing facility" "is not required to complete a new Pre-Admission Screening (PAS) form." (Rule 2.8.D.6).

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

Two weeks' notice — the licensure standard, Rule 45.17.2(4): the resident "is given a two week advance notice in" "writing to ensure orderly transfer or discharge."

Thirty calendar days' notice — the Medicaid rule, Rule 2.20.A.1: "The notice of transfer or discharge must be given at least thirty (30) calendar days prior to" "the transfer or discharge unless:" the four exceptions quoted in section 01 above. Neither this period nor the licensure standard's two weeks is reconciled with the other in either document.

Thirty days to request a hearing — Rule 2.8.A: "The applicant or beneficiary has thirty (30) days from the postmark date of the appropriate notice to request either a local or state hearing." Extendable for good cause under the same rule.

Ten days for a timely continuation-of-benefits request — Rule 2.21.A.1: "the request must be received by the regional office within ten (10) days from the notice date of the adverse action."

Fifteen days to request a state hearing and keep benefits continuing — Rule 2.21.B.2: "If benefits have been continued pending the local hearing, then benefits will continue" "pending a state hearing decision as long as the request for the state hearing is made within" "fifteen (15) days of the date on the Notice of Local Hearing Decision."

Ninety days for a final decision — Rule 2.9: "The Division of Medicaid must take final administrative action on a hearing, whether state" "and/or local, within ninety (90) days of the date of the initial request for a hearing."

Fifteen consecutive days, up to forty-two days a year — home/therapeutic temporary leave, Rule 2.8.C, quoted in full in section 02 above.

Fifteen consecutive days, no annual cap — inpatient hospital temporary leave, Rule 2.8.D, quoted in full in section 02 above.

Twenty-four hours — the gap the nursing facility must let pass before a new leave period can begin once either fifteen-day allowance is exhausted: "a" "new leave of absence for home/therapeutic temporary leave does not begin until the" "resident has returned to the nursing facility for twenty-four (24) hours or longer." (Rule 2.8.C.6), and, for the inpatient allowance, "a" "new leave of absence for acute hospitalization does not begin until the resident has" "returned to the nursing facility for a period of twenty-four (24) hours or longer." (Rule 2.8.D.5).

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

Source map

Captured: all six, in tools/packets/mississippi-packet.txt. Pending: Miss. Code Ann. § 43-11-13 (the licensure statute Rule 45.17.2 is issued under, cited but not itself fetched as a separate provision); DOM 350 (Request for Local Hearing) and DOM 352 (Request for State Hearing), the forms Rule 2.7 names but does not reproduce; a first-party page giving the Office of Administrative Appeals' own filing address, phone number, or portal; and the health department's facility complaint page.

Change log

2026-09-21 — Deepened to a full page: section 01 (the grounds, as Mississippi 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) are now written. Newly captured, both from the Division of Medicaid's own PDFs by the existing recipe (tools/recipes/mississippi.json, extended with sources 5-7; recipe digest ca85686f9a9a, was 7e0c7111b9c0): Rule 2.8, Temporary Leave (Title 23 Part 207), which is Mississippi's bed-hold provision; and, from Title 23 Part 300 (Appeals), Rule 2.3 through Rule 2.9 (appeal rights, hearing types, filing routes, the 30-day filing period, and the 90-day decision timeframe) and Rule 2.21 (Continuation of Benefits, the pendency provision). Transport: curl with a browser user-agent, pdftotext-layout, sliced by heading anchor, the same transport already recorded for this state's first four sources. Part 300 prints its own table of contents on its first two pages, and the first attempt at each new Part 300 slice anchored there instead of in the body — the exact trap CLAUDE.md names for long documents — producing a two-line capture of nothing but a contents entry; both anchors were corrected to from_occurrence 2 before promoting the capture, and the flawed first attempt is retained in tools/packets/history/mississippi/2026-09-21.txt as the record of what happened, superseded by 2026-09-21-b.txt. Findings, continuing the numbering from 2026-08-30: (8) Neither Rule 2.20 nor Part 300 cross-references the other. Rule 2.20's notice requirement points to "the appropriate state" "authorities," without naming one; Part 300's Rule 2.3.A.4 names "Beneficiaries who are subject to a proposed transfer or discharge from a long-term care" "facility or nursing facility," as one of its six appeal categories, without citing Rule 2.20 or Title 23 Part 207 at all. This page connects the two rules on the strength of Rule 2.3.A.4 alone; that connection is this page's, not either publisher's own statement. (9) Part 300 states no street address, telephone number, or filing form for the regional office, the central office, or the Office of Administrative Appeals it names as the filing routes. (10) Rule 2.21's pendency provision is written for Medicaid "benefits" generally and never uses the words "discharge" or "transfer"; whether "benefits" as the rule uses the term reaches continued residence at the nursing facility during a Rule 2.20 appeal is not stated in the sources reviewed, and this page states that absence rather than assuming either reading. (11) The ombudsman program's recaptured page (source 4) is 6,846 characters after whitespace collapse against 7,474 at the 2026-09-04 capture; the difference is a Google Tag Manager noscript block and a county-name dropdown list that no longer appear in the served markup, not a change to any text this page quotes — every phrase quoted from that source above was confirmed present and unchanged in both captures before promoting the recapture. Capture pending, continuing the 2026-08-30 list, now narrowed: Miss. Code Ann. § 43-11-13; DOM 350 and DOM 352, named in Rule 2.7 but not reproduced there; a first-party page giving the Office of Administrative Appeals' own filing address, phone number, or portal; and the health department's facility complaint page. The Division of Medicaid's fair-hearing rule and a first-party bed-hold statement, both pending as of 2026-08-30, are captured as of this entry. Internet Archive: not yet submitted for the three newly captured sources. Reviewer: Carrie Schluter, reviewed 2026-09-21. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Mississippi packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Mississippi 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) Mississippi publishes two different notice periods for the same event: two weeks in the health department's licensure standard at Rule 45.17.2(4), and thirty calendar days in the Division of Medicaid's Rule 2.20. Both are quoted as published; neither document acknowledges the other, and this page reconciles nothing. Oklahoma is the only other state built so far with a conflict of this kind inside its own materials. (2) No captured Mississippi source names the office that hears a discharge appeal. The Medicaid rule requires the notice to state a right to appeal to "the appropriate state" "authorities," and stops; the ombudsman page sends the reader to the Division of Medicaid's website without naming a rule, an office or a deadline. The hearing row states that absence rather than filling it. (3) The licensure standard states the grounds as a resident right rather than as a rule addressed to the facility, and states no required contents for the notice at all. (4) The Medicaid rule's fourth shortening circumstance — that the resident has not resided in the facility for thirty calendar days — has no counterpart in the licensure standard, which admits no exception to its two weeks. (5) The department's own ombudsman URLs under /divisions-programs/ and /aging-adult-services/ return 404 after a site rebuild; the live page is at /ombudsman/, and the packet records both so a later session does not read the 404 as a removed programme. (6) The ombudsman page states that the facility must give the notice to the ombudsman programme as well as the resident, which neither regulation in this packet states. (7) No first-party statement of a Mississippi bed-hold or temporary-leave period was captured. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.