Nebraska

The grounds, as Nebraska describes them

Neb. Rev. Stat. § 71-6022(1) states the grounds in one sentence: "A nursing home shall not transfer or discharge a resident except"

"(a) upon his or her consent,"

"(b) for medical reasons,"

"(c) for the resident's safety or the safety of other residents or nursing home employees,"

"(d) when rehabilitation is such that movement to a less restrictive setting is possible, or"

"(e) for nonpayment for the resident's stay, except as prohibited by section 71-6023.01 or by Title XVIII or XIX of the Social Security Act as amended."

The department's own licensure regulation, 175 NAC 12-006.05(5), restates the same five grounds as a resident right rather than as a facility power: "Be free from arbitrary transfer or discharge. The resident must be informed at the time of admission that he or she may be transferred or discharged only upon the following terms: a. Upon his or her consent; b. For medical reasons, which must be based on the resident's needs and be determined and documented by a physician; c. For the resident's safety or the safety of other residents or facility employees; d. When rehabilitation is such that movement to a less restrictive setting is possible; or e. For nonpayment of the resident's stay, except as prohibited by Title XVIII or XIX of the Social Security Act as amended, or the Nebraska Nursing Home Act, Neb. Rev. Stat. §§ 71-6008 to 71-6037." The regulation adds a numeric floor to the nonpayment ground that the statute states only by cross-reference: "must not include a change in resident economic status so that the resident receives Medicaid or becomes eligible for Medicaid if the resident has resided in the facility for a period of at least one year after July 17, 1986, unless 10% of the facility's residents are receiving Medicaid or are eligible for Medicaid. This provision does not apply to Nebraska Veterans' Homes established under Chapter 80, Article 3 of Nebraska Statutes."

The published process

Requesting the hearing

No licensure source — not the statute, not 175 NAC 12, not the ombudsman's own page — states where an appeal of a transfer or discharge goes. The route exists only in Nebraska's Medicaid nursing-facility regulation, 471 NAC 12-007.21: "A resident of a skilled nursing facility (SNF) or a nursing facility (NF) who receives a notice from the skilled nursing facility (SNF) or nursing facility (NF) of the intent to discharge or transfer the resident may appeal to the Department of Health and Human Services for a hearing on this notice. The appeal and hearing must be conducted under 465 NAC 2 and 6." That chapter, the department's general grievances-and-fair-hearings rule, states the request "is made to the Director of the Department of Social Services and forwarded to the attention of the Legal Services Division." Filing itself is described in 465 NAC 6-004.01: "The contested case begins with the filing of a petition and request for hearing, if applicable, with the Department." Form DA-6, "Notice and Petition for Fair Hearing," is available for filing an appeal to anyone who requests it at any office of the Department, and "An individual's request for a hearing may also be made in the form of an simple letter or written request to the Department, provided the request identifies the basis for appeal."

The chapter states a filing deadline and a pendency provision, both written for the general public-assistance appeal the chapter otherwise governs rather than restated specifically for a nursing-facility discharge: "The applicant or client must request a fair hearing within 90 days following the date the notice of adverse action is mailed." And on pendency: "If the client submits a request for a hearing within ten days following the date the notice is mailed, the staff shall not take the adverse action until a fair hearing decision is rendered." The chapter also states "The hearing must be scheduled not less than one week nor more than six weeks from the date of the request, unless the time is waived by the petitioner." No street address, fax number, email address, or online filing portal is stated in any source reviewed, for either the discharge appeal or the chapter it is filed under.

The notice's required contents

Neb. Rev. Stat. § 71-6023(1): "The notice required by subsection (2) of section 71-6022 shall contain: (a) The stated reason for the proposed transfer or discharge; (b) The effective date of the proposed transfer or discharge; and (c) In not less than twelve-point type, the text of section 71-445." Section (2) adds who receives it: "A copy of the notice required by subsection (2) of section 71-6022 shall be transmitted to the resident and the resident's representative, if a representative has been designated." Section 71-445, the text the notice must carry in full, states: "A health care facility or health care service shall not discriminate or retaliate against a person residing in, served by, or employed at such facility or service who has initiated or participated in any proceeding authorized by the Health Care Facility Licensure Act or who has presented a complaint or provided information to the administrator of such facility or service or the Department of Health and Human Services. Such person may maintain an action for any type of relief, including injunctive and declaratory relief, permitted by law." Nebraska does not require the notice to state an appeal right, a hearing office, or the ombudsman's contact information; only the anti-retaliation text is mandated.

Bed-hold and return

No licensure source states a bed-hold period; that absence stood at baseline. Nebraska's Medicaid nursing-facility regulation, 471 NAC 12, does state one. 471 NAC 12-007.12: "BED-HOLDING POLICIES FOR HOSPITAL AND THERAPEUTIC LEAVE. The facility must develop policies as defined in 42 CFR 483.15(d)." The facility must give two notices — 471 NAC 12-007.13, on admission or policy change: "The facility must provide written information to the client and a family member or legal representative that specifies: (A) The duration of the bed-hold policy during which the client is permitted to return and resume residence in the facility; and (B) The facility's policies regarding bed-hold periods which must be consistent with 42 CFR 483.15(d)." — and 471 NAC 12-007.14, at the time of transfer: "the facility must provide written notice to the client and a family member or legal representative which specifies the duration of the bed-hold policy." On return, 471 NAC 12-007.15: "The facility must establish and follow a written policy under which a client whose leave exceeds the bed-hold period is re-admitted to the facility immediately upon availability of a bed if the client: (A) Requires the services provided by the facility; and (B) Is eligible for Medicaid nursing facility services."

The regulation's payment section states the periods the department will actually fund, under 471 NAC 12-007.25(K): "The Department makes payments to reserve a bed in a nursing facility (NF) during a client's absence due to hospitalization for an acute condition and for therapeutically-indicated home visits." Two limits are stated: "Hospital bed-holding is limited to reimbursement for 15 days per hospitalization." and "Therapeutic leave bed-holding is limited to reimbursement for 18 days per calendar year. Bed-holding days are prorated when a client is a resident for a partial year". "When the limitation for therapeutic leave interferes with an approved therapeutic or rehabilitation program, the facility may submit a request for special limits of up to an additional six days per calendar year to Medicaid."

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Nebraska'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, ordinarily — Neb. Rev. Stat. § 71-6022(2): "Involuntary transfer from a nursing home or discharge of a resident shall be preceded by a minimum written notice of thirty days".

Five days, for a move to a less restrictive setting — the same subsection: "when subdivision (d) of subsection (1) of this section applies, five days written notice shall be given to the resident or his or her representative".

Ten days, for arrears of five days or more — the same subsection: "when subdivision (e) of subsection (1) of this section applies, a resident shall be given ten days' written notice if his or her charges are five days or more in arrears."

No notice, for two stated emergencies — the same subsection: "This subsection shall not apply when (a) an emergency transfer or discharge is mandated by the resident's health care needs and is in accord with the written orders and medical justification of the attending physician or (b) the transfer is mandated by the physical safety of other residents or nursing home employees, as documented in the nursing home records."

Ninety days to request a fair hearing — 465 NAC 2-001.02A: "The applicant or client must request a fair hearing within 90 days following the date the notice of adverse action is mailed."

Ten days for the stay to attach — the same subsection: "If the client submits a request for a hearing within ten days following the date the notice is mailed, the staff shall not take the adverse action until a fair hearing decision is rendered."

One to six weeks to schedule the hearing — 465 NAC 2-001.02C: "The hearing must be scheduled not less than one week nor more than six weeks from the date of the request, unless the time is waived by the petitioner."

Fifteen days of hospital bed-holding — 471 NAC 12-007.25(K): "Hospital bed-holding is limited to reimbursement for 15 days per hospitalization."

Eighteen days of therapeutic-leave bed-holding per year, with a possible six-day extension — the same subsection: "Therapeutic leave bed-holding is limited to reimbursement for 18 days per calendar year." and 007.25(K)(i): "the facility may submit a request for special limits of up to an additional six days per calendar year".

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

Source map

Captured: all ten, in tools/packets/nebraska-packet.txt. Pending: any Medicaid fair-hearing provision specific to a nursing-facility discharge (as distinct from the general chapter 2/6 process quoted above), a street address, fax, email or online portal for filing, and the ombudsman contacts map.

Change log

2026-09-22 — Deepened to a full page. Two new first-party sources were captured beyond the four used at baseline: 471 NAC 12, Nebraska Medicaid's nursing-facility regulation (distinct from the 175 NAC licensure chapter already held), and 465 NAC 2 and 6, the department's general grievances-and-fair-hearings and contested-case chapters. All were captured by curl through this state's recipe (tools/recipes/nebraska.json, sources 6 through 10), the same transport already in use for the other four sources.

Findings: (1) The baseline page's hearing-office row stated flatly that no captured source named an appeal route. That was true of the licensure statute and regulation, and remains true of them; it is not true of the whole state. 471 NAC 12-007.21 states that a discharge or transfer appeal goes to the Department of Health and Human Services, conducted under 465 NAC 2 and 6 — found only because this pass looked at Nebraska's Medicaid regulation rather than only its licensure code, the two publishers CHARTER.md's four-publisher-per-state observation anticipates. The docket's hearing-office row is corrected accordingly; this is exactly the kind of docket change section 02 is permitted to drive. (2) The appeal route 007.21 names is not written for nursing-facility discharges specifically. 465 NAC 2 and 6 are the department's general fair-hearing chapters, covering "all benefit and services programs administered by the Nebraska Department of Social Services" and, by the chapter's own terms, having "general application to other Department functions such as licensing, certification, and provider authorization." 007.21 invokes the chapters wholesale and states no discharge-specific deadline of its own (it states the PASRR-appeal deadline separately, as ninety days); this page quotes chapter 2's general ninety-day and ten-day provisions as what 007.21 points to, not as language written for this specific appeal, and says so. (3) A dating discrepancy, not resolved. The compiled Title 465 manual PDF (dhhs.ne.gov/Documents/Title-465-Complete.pdf) carries a running head reading "REV. AUGUST 21, 1995" on every page of chapters 2 and 6 quoted here. The department's own Title 465 index page, captured as source 10, currently states "Chapter 2 Amended 9/17/2024" and "Chapter 6 Amended 9/17/2024". No occurrence of "2024" appears anywhere in the compiled PDF's text. Both are quoted as published; this page does not decide which text currently governs, and a working session should look for a 2024-dated version of chapters 2 and 6 that the compiled PDF at this address does not yet reflect. (4) 471 NAC 12 states Nebraska's bed-hold policy, absent at baseline: a facility must hold a bed under a policy consistent with 42 CFR 483.15(d), and the Department separately funds up to 15 days of hospital bed-holding and 18 days of therapeutic-leave bed-holding per year (extendable by up to 6 days on request). Readmission is required "immediately upon availability of a bed" for a client who still requires the facility's services and remains Medicaid-eligible. (5) Recipe drift, corrected. Source 5's anchor (the ombudsman page) began with the page's hidden "Page Content" field-label text, which no longer appears in a fresh extraction of dhhs.ne.gov/Pages/Aging-Ombudsman.aspx — the page's own markup changed; capture.py was not touched. The anchor now starts at "The Long-Term Care Ombudsman (LTCO)"; the quoted text itself is unchanged, and all pre-existing quotations from this source still verify. (6) The notice's required contents and the grounds section restate what the baseline docket already quoted from §§ 71-6022, 71-6023, 71-445 and 175 NAC 12-006.05; no new source was needed for either. Capture pending: per the source map. Internet Archive: not yet submitted for the five new sources. Reviewer: Carrie Schluter, reviewed 2026-09-22.

2026-09-04 — Quotation correction: a space this page supplied. The notice-contents quotation in the docket carried a space before the period in "the text of section 71-445 ." The Legislature does not print that space: its markup sets the section number as a link, "section <a>71-445</a>.", and the space was inserted at the link boundary by the 2026-08-30 capture's tag strip, not by the publisher. The error was ours, and the page inherited it from our own capture. The space has been dropped; no wording changed. Verified against the live markup of the statute page and against a fresh recipe-driven capture, which renders the sentence without the space. Found while writing this state's capture recipe, when the new capture stopped matching the old quotation — the recipe backfill's first catch of this kind here. Reviewer: Carrie Schluter, reviewed 2026-09-04. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Nebraska packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Nebraska 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) Nebraska states three notice periods in a single subsection, each tied to a different ground — thirty days ordinarily, five for a move to a less restrictive setting after rehabilitation, ten for arrears of five days or more — plus two circumstances in which no notice is required. No other state built so far keys the period to the ground in this way. (2) No captured Nebraska source states an appeal: not the statutes, not the department's regulation, not the ombudsman page. The hearing row states that absence rather than filling it, and nothing is borrowed from federal law. (3) The text the notice must carry in twelve-point type is § 71-445, the anti-retaliation provision, not a statement of appeal rights. The regulation reprints that text in full, and its reprint names three departments — Health and Human Services, Health and Human Services Finance and Support, and Health and Human Services Regulation and Licensure — which the current statute does not, the agencies having been consolidated since. Both are quoted as published and this page does not reconcile them. (4) The regulation's running head reads EFFECTIVE 2/27/07, and its text still refers to the pre-consolidation department names; a more recent chapter 12 was not found in the department's own compilation, and that is recorded rather than assumed. (5) The nonpayment ground carries a Medicaid protection with a numeric condition — a resident of at least one year's standing, unless ten per cent of the facility's residents are on or eligible for Medicaid — which is quoted as published. (6) Two of the department's ombudsman URLs return 404 after a site rebuild; the live page is /Pages/Aging-Ombudsman.aspx, and the packet records all three so a later session does not read a 404 as a removed programme. (7) No first-party statement of a Nebraska bed-hold 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.