Nevada
- Grounds stated in the sources
- The Bureau of Health Care Quality and Compliance's own licensing rule for skilled-nursing facilities, NAC 449.74429(1), states that "A facility for skilled nursing may" "transfer or discharge a patient from the facility only if:" the facility "can no longer provide for the" "needs of the patient and the transfer or discharge is necessary for the" "patient’s welfare"; "The health of the patient has improved" "sufficiently so that the patient no longer requires the services provided by" "the facility"; "The health or safety of other persons in the" "facility is endangered if the patient remains in the facility"; "The charges for services provided to the" "patient by the facility have not been paid after the facility has given notice" "of those charges; or" "The facility ceases to operate." A separate Nevada statute chapter enumerates grounds in nearly identical terms, but for a different facility type: NRS 449A.282 limits transfer or discharge "except where" the same five circumstances apply, and states them only of "A residential facility for groups" — a facility type this project's charter places out of v1 scope, distinct from "a facility for skilled nursing" throughout NAC 449.74429 and NRS 449A.114 below.
- Notice stated in the sources
- Two Nevada publishers state the same period. NAC 449.74429(2)(b)(3) requires that the notice "be given at least 30 days before the effective date of the transfer or" "discharge," and NRS 449A.114(1)(a) requires a facility to, "At least 30 calendar days before transferring" "or discharging the patient, provide the patient and the Ombudsman with written" "notice of the intent to transfer or discharge the patient". NRS 449A.114(1)(b) adds a right NAC 449.74429 does not state: "Within 10 calendar days after providing" "written notice to the patient or resident and the Ombudsman pursuant to" "paragraph (a), allow the patient and any person authorized by the patient the" "opportunity to meet in person with the administrator of the facility to discuss" "the proposed transfer or discharge." On contents, NAC 449.74429(2)(b) requires the notice to "Include the reasons for the transfer or" "discharge," "Include the effective date of the transfer" "or discharge," "Specify the location to which the patient" "will be transferred or discharged", "Include a statement that the patient has a" "right to appeal the transfer or discharge", and "Include the name, address and telephone" "number of the advocates for residents of facilities for long-term care" "appointed pursuant to chapter 427A of" "NRS." The 30-day period may be shortened under NAC 449.74429(3) where "The health or safety of other persons in the" "facility is endangered if the patient remains in the facility", where the patient's health has improved enough to allow a more immediate move, where "The medical needs of the patient require a more" "immediate transfer or discharge", or where "The patient has not resided in the facility for" "at least 30 days." NRS 449A.114(2) states two further exceptions: a voluntary discharge "at the" "request of the patient", and a transfer made because the patient's condition "necessitates an immediate transfer to a" "facility for a higher level of care."
- Hearing office in these sources
- NAC 449.74429(2)(b)(7) requires only that the notice "Include a statement that the patient has a" "right to appeal the transfer or discharge" — it names no office. The office is named in the Division of Health Care Financing and Policy's own Medicaid Services Manual, Chapter 3100: "the state will provide a system for a resident of a NF to appeal" "a notice from the NF of intent to discharge or transfer the resident. Upon receipt of the" "discharge notice, the resident may request a Fair Hearing via the internet, telephonically, in" "person, through other commonly available electronic means or by submitting the request to" "the DHCFP." A standard request "must be received by the DHCFP office within 90 calendar days" "from the Notice Date"; an Expedited Fair Hearing is available where a standard hearing's timing "could" "jeopardize the individual's life, health or ability to attain, maintain or regain" "maximum function", with "A decision" "provided within" "seven working days from when the Hearing request was received." Nevada Medicaid's own Fair Hearing Request Form (NMO-6300) states the filing address: "Nevada Medicaid Hearings Unit" "9850 Double R Blvd Ste. 200" "Reno, NV 89521" fax "(775) 684-3610," email "medicaidhearings@nvha.nv.gov".
- Ombudsman in these sources
- "The Nevada State Long Term Care Ombudsman Program (LTCOP) is authorized by the federal Older American's Act." Its published helpline: "please contact LTCOP Helpline at" "1-888-282-1155". The program's own discharge-rights brochure lists a Carson City office at "3416 Goni Rd. Suite 132" "Carson City, NV 89706" "(775) 687-4210", and three others: Elko at "1010 Ruby Vista Dr. Suite 104" "Elko, NV 89801", "(775) 738-1966"; Las Vegas at "3320 W. Sahara Ave" "Las Vegas, NV 89104", "(702) 486-3545"; and Reno at "9670 Gateway Dr. Suite 100" "Reno, NV 89521" "(775) 687-0800". The Aging and Disability Services Division's own program page carries a different Carson City street address under the same phone number: "1550 E College Parkway" "Carson City, NV 89706" "(775) 687-4210". Both are shown; neither is reconciled here.
- Sources last checked
- Oct 6, 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 Nevada's own publishers state about transfer and discharge from a nursing facility. Nevada's fullest single source is NAC 449.74429, the Board of Health's rule on "Transfer or discharge of patient", adopted effective 9-27-99: it alone states the grounds, the notice's required contents, the 30-day period and its exceptions, and the facility's bed-hold disclosure duty. A companion statute, NRS 449A.114, adds notice to the Ombudsman and a 10-day right to meet with the administrator. Nevada's own vocabulary is transfer or discharge, matching the federal regulation's term. Three publishers speak here: the Legislature's own codification of the Board of Health's rule and the relevant statutes; the Division of Health Care Financing and Policy's Medicaid Services Manual, which names the hearing office the notice-content rule does not; and the Aging and Disability Services Division, which publishes the Long-Term Care Ombudsman Program.
Two things a reader should see at once. Nevada regulates two different kinds of long-term-care facility under overlapping but distinct provisions, and a search that stops at NRS chapter 449A's "Limitations on transfer or involuntary discharge" (NRS 449A.282) will land on the wrong one: those sections, and the two notice statutes beside them, apply on their own terms only to a "residential facility for groups," not to "a facility for skilled nursing". The grounds, notice contents, and bed-hold disclosure duty that actually govern a skilled-nursing facility sit instead in NAC 449.74429 and NRS 449A.114, both quoted above. And Nevada Medicaid's own reimbursement for holding a bed — up to 24 days a year — is stated only for "therapeutic leave," which its own manual defines to exclude "hospital emergency room visits or hospital stays"; no source found states whether or how a hospital-stay bed-hold is itself reimbursed, only that a facility must adopt and disclose its own policy for one. 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 Nevada describes them
NAC 449.74429(1) states, "A facility for skilled nursing may transfer or discharge a patient from the facility only if:" in the rule's own order (leg.state.nv.us, added by the Board of Health, effective 9-27-99, retrieved 2026-09-01):
(a) "The facility can no longer provide for the needs of the patient and the transfer or discharge is necessary for the patient’s welfare".
(b) "The health of the patient has improved sufficiently so that the patient no longer requires the services provided by the facility".
(c) "The health or safety of other persons in the facility is endangered if the patient remains in the facility".
(d) "The charges for services provided to the patient by the facility have not been paid after the facility has given notice of those charges".
(e) "The facility ceases to operate."
A separate Nevada statute states the same five circumstances almost word for word, but for a different, out-of-scope facility type: NRS 449A.282 limits transfer or discharge only where equivalent conditions apply, stated only of a "residential facility for groups" — assisted-living-type housing this project's charter places outside v1 scope, distinct from "a facility for skilled nursing" throughout NAC 449.74429 and NRS 449A.114 below. See the change log.
The published process
Requesting the hearing
NAC 449.74429(2)(b)(7) requires the notice to "Include a statement that the patient has a right to appeal the transfer or discharge;" — it names no office. The office is named only in the Division of Health Care Financing and Policy's own Medicaid Services Manual, Chapter 3100: "Pursuant to 42 CFR §483.204, the state will provide a system for a resident of a NF to appeal a notice from the NF of intent to discharge or transfer the resident." "Upon receipt of the discharge notice, the resident may request a Fair Hearing via the internet, telephonically, in person, through other commonly available electronic means or by submitting the request to the DHCFP." For a Standard Fair Hearing, "The request must be received by the DHCFP office within 90 calendar days from the Notice Date", unless the recipient shows good cause. An Expedited Fair Hearing is available if "the time permitted for a Standard Fair Hearing could jeopardize the individual’s life, health or ability to attain, maintain or regain maximum function"; for the NF-resident route specifically, "A decision will be provided within seven working days from when the Hearing request was received." No captured source states whether requesting a hearing — standard or expedited — stays the transfer or discharge pending the decision.
Nevada Medicaid's own Fair Hearing Request Form (NMO-6300) states the filing address: "Nevada Medicaid Hearings Unit" "9850 Double R Blvd Ste. 200" "Reno, NV 89521", fax "(775) 684-3610," email "medicaidhearings@nvha.nv.gov".
The notice's required contents
NAC 449.74429(2)(b): the notice must "Be in writing;" "Be in a language that is understood by the patient and his or her legal representative or a member of his or her family;" "Except as otherwise provided in subsection 3, be given at least 30 days before the effective date of the transfer or discharge"; "Include the reasons for the transfer or discharge;" "Include the effective date of the transfer or discharge;" "Specify the location to which the patient will be transferred or discharged;" "Include a statement that the patient has a right to appeal the transfer or discharge;" "Include the name, address and telephone number of the advocates for residents of facilities for long-term care appointed pursuant to chapter 427A of NRS;" and "If the patient is developmentally disabled or mentally ill, include the name, address and telephone number of persons who advocate for and are responsible for the protection of such persons."
NRS 449A.114 adds two duties NAC 449.74429 does not state: a facility must, "At least 30 calendar days before transferring or discharging the patient, provide the patient and the Ombudsman with written notice of the intent to transfer or discharge the patient", and, "Within 10 calendar days after providing written notice to the patient or resident and the Ombudsman pursuant to paragraph (a), allow the patient and any person authorized by the patient the opportunity to meet in person with the administrator of the facility to discuss the proposed transfer or discharge." NRS 449A.114(2) exempts the section entirely where a discharge is voluntary, "at the request of the patient", or where "the condition of the patient necessitates an immediate transfer to a facility for a higher level of care."
Bed-hold and return
Two Nevada publishers address return after an absence, at different scopes. NRS 449.183(1) requires every facility to "shall adopt a written policy that establishes:" "The number of days the facility will hold the bed of a patient or resident for his or her return if the patient or resident is transferred temporarily to a hospital or other facility for medical reasons"; and "That a patient or resident who is so transferred for a period that exceeds the period of the hold established pursuant to paragraph (a) will be allowed to resume his or her residency as soon as a bed becomes available, if the facility is suitable for properly caring for the patient upon his or her return." NAC 449.74429(4) states the same disclosure duty for a facility for skilled nursing specifically: upon admission and at the time of a hospitalization or therapeutic-leave transfer, the facility must state in writing "The time within which the patient may resume his or her residency in the facility without waiting for readmission" and "The policy of the facility for readmitting a patient whose hospitalization or therapeutic leave exceeds the time within which he or she may resume his or her residency in the facility without waiting for readmission upon the first availability of a bed in a semiprivate room." Neither source states a statewide number of bed-hold days; both require the facility to adopt and disclose its own.
Nevada Medicaid's own reimbursement is stated only for "Therapeutic Leave", defined to exclude a hospital stay: "Therapeutic leave does not include hospital emergency room visits or hospital stays." Where it applies, "NFs will be reimbursed their per diem rate for reserving beds for Medicaid recipients who are absent from the facility on therapeutic leave up to a maximum of 24 days annually." and "The NF must reserve and hold the same room and bed for the Medicaid recipient on a therapeutic leave for the dates specified in the physicians order." (the manual's own text, without an apostrophe in "physicians"). No source captured for this page states whether or how a hospital-stay bed-hold itself is reimbursed.
The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Nevada'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 under the licensing rule — NAC 449.74429(2)(b)(3): the notice must, "Except as otherwise provided in subsection 3, be given at least 30 days before the effective date of the transfer or discharge".
Thirty days' advance notice to the patient and the Ombudsman under the statute — NRS 449A.114(1)(a): "At least 30 calendar days before transferring or discharging the patient, provide the patient and the Ombudsman with written notice of the intent to transfer or discharge the patient".
Ten days to meet with the administrator — NRS 449A.114(1)(b), quoted in full above.
Ninety calendar days to request a Standard Fair Hearing — the Medicaid Services Manual, Chapter 3100: "The request must be received by the DHCFP office within 90 calendar days from the Notice Date", unless the recipient shows good cause.
Seven working days to a decision on an NF resident's Expedited Fair Hearing — the Medicaid Services Manual, Chapter 3100: "A decision will be provided within seven working days from when the Hearing request was received."
Twenty-four days a year of Medicaid-reimbursed therapeutic leave — the Medicaid Services Manual, Chapter 500: "NFs will be reimbursed their per diem rate for reserving beds for Medicaid recipients who are absent from the facility on therapeutic leave up to a maximum of 24 days annually."
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 |
|---|---|---|---|
| NAC 449.74429, Transfer or discharge of patient (Facilities for Skilled Nursing) | Nevada Legislature, Nevada Administrative Code Chapter 449 | added by the Board of Health, effective 9-27-99 | 2026-09-01 |
| NRS 449A.114, Certain facilities to notify patient and State Long-Term Care Ombudsman of intent to transfer patient | Nevada Legislature, Nevada Revised Statutes Chapter 449A | added 2019; amended 2021, 2023 | 2026-09-01 |
| NRS 449.183, written bed-hold policy required of the facility | Nevada Legislature, Nevada Revised Statutes Chapter 449 | added 2011 | 2026-09-01 |
| NRS 449A.282 and 449A.284, transfer/discharge limitations for a residential facility for groups (out-of-scope facility type, captured to document the distinction) | Nevada Legislature, Nevada Revised Statutes Chapter 449A | added 2023 | 2026-09-01 |
| Medicaid Services Manual, Chapter 500 — Nursing Facilities, Section 503.5, Therapeutic Leave of Absence | Nevada Medicaid, Division of Health Care Financing and Policy (PDF) | effective July 1, 2025 | 2026-09-01 |
| Medicaid Services Manual, Chapter 3100 — Hearings | Nevada Medicaid, Division of Health Care Financing and Policy (PDF) | site labels current, effective Feb 23, 2018 | 2026-09-01 |
| Fair Hearing Request Form, NMO-6300 | Nevada Medicaid (PDF) | NMO-6300 (6/25) | 2026-09-01 |
| Long Term Care Ombudsman | Nevada Aging and Disability Services Division | none stated on page | 2026-09-01 |
| Nursing Home Discharges, Transfers, and Room Changes: Know Your Rights (brochure) | Nevada Aging and Disability Services Division, Long Term Care Ombudsman Program (PDF) | none stated | 2026-09-01; at its moved address 2026-09-25 |
Captured: all nine, in tools/packets/nevada-packet.txt (2026-09-01); the brochure again at its moved address in tools/packets/nevada-packet-moved.txt (2026-09-25). Pending: the Bureau of Health Care Quality and Compliance's own complaint and investigation materials; any Nevada Medicaid statement of a reserve-bed or per-diem policy specific to a hospital stay; and any published statement from the Bureau addressing transfer or discharge directly.
Change log
2026-10-06 — Correction: finding (3) of the 2026-09-01 entry below, that Nevada's own regulatory text omits the apostrophe in "patient's" throughout NAC 449.74429, was wrong, and is retracted. The omission was ours. The Legislative Counsel Bureau serves the NAC and NRS pages as Windows-1252 with no character set declared, and prints the possessive apostrophe as a single byte; the 2026-09-01 capture dropped that byte, so the packet read "patients welfare", "patients physician" and "patients family", and this page recorded the missing apostrophe as the rule's own typo and quoted "patients welfare" as published. The 2026-10-06 nightly review recaptured the rule and it failed fidelity on those two quotations; read against the raw bytes of the source, the apostrophe is and was present. The capture recipe now declares the source's encoding (tools/recipes/nevada.json, sources 1 through 4; tools/capture.py, new opt-in encoding key), and the two quotations in section 01 and in the grounds docket row now read "patient's welfare" as the rule prints it, in the curly form the source carries. The Medicaid Services Manual's omission in Chapter 3100 ("the residents request for a Fair Hearing") is a separate source, was not affected, and stands. Nothing else on this page changed, and the apostrophe was never a change by the Legislative Counsel Bureau. The recipe was also finished on this date: its nine sources were sliced to the sections this page quotes (the standing packet's hand-made excerpts are replaced by a recipe capture of those sections), and the retained capture of 2026-10-06 is the new standing packet; the sources-last-checked date is 2026-10-06. The earlier drift handoff FA-Q-20261006-02 is closed. Reviewer: Carrie Schluter (review confirmed 2026-10-06). Corrections: hello@fieldassembly.net.
2026-09-25 — Correction: the link to the ombudsman program's discharge-rights brochure in the source map was broken, for two reasons, and now points to the address the division serves the brochure from today. First, this site's own renderer ended a link at the first closing parenthesis in its address, so the published link stopped at "Brochure(2" and returned HTTP 404 to every reader; that was our error, not the publisher's. Second, the Aging and Disability Services Division has moved its uploaded files: the address this page carried since 2026-09-01, https://www.adsd.nv.gov/uploadedFiles/adsdnvgov/content/Programs/Seniors/LTCOmbudsman/LTC%20Discharges%20Brochure(2).pdf, now redirects (HTTP 301) to https://www.adsd.nv.gov/siteassets/content/programs/seniors/ltcombudsman/LTC_Discharges_Brochure_2.pdf, which is the address now linked. The division's own Long Term Care Ombudsman page still links the old address. The brochure itself has not changed: it was re-captured mechanically from the new address into a supplement, tools/packets/nevada-packet-moved.txt (recipe tools/recipes/nevada-moved.json), its text matches the standing packet's source 9 line for line, and every quotation, address and telephone number this page takes from the brochure verifies against the new capture alone. No wording on this page changed. The standing packet was not rebuilt and its 2026-09-01 retrieval dates stand; the sources-last-checked date is unchanged, because only this one source was re-fetched. Reviewer: Carrie Schluter, reviewed 2026-09-25. Corrections: hello@fieldassembly.net.
2026-09-23 — Deepened to a full page: sections 01 (the grounds, as Nevada describes them) and 02 (the published process — requesting the hearing, the notice's required contents, bed-hold and return, and the notice-periods register) are now written. No new sources were needed this pass; the full page is built entirely from the standing packet captured 2026-09-01, which already carried the section-02 evidence — NAC 449.74429 in full (grounds, notice contents, and the bed-hold disclosure duty), NRS 449A.114 (ombudsman notice and the administrator-meeting right), NRS 449.183 (the licensure bed-hold policy duty), and the Medicaid Services Manual's Chapter 3100 (the Fair Hearing route and deadlines) and Chapter 500 (the therapeutic-leave reimbursement cap). Findings (1) through (7), recorded 2026-09-01, stand unchanged and are carried into sections 01 and 02 rather than restated as new findings. (8) No captured source states whether requesting a Standard or Expedited Fair Hearing stays a transfer or discharge pending the decision — Nevada publishes no pendency provision comparable to New Hampshire's court-petition stay or Ohio's ten-day hold, an absence recorded here because the Fair Hearing chapter that names the route was successfully captured and reviewed in full. tools/recipes/nevada.json remains an unpromoted draft (drafted by tools/draft-recipe.py, never run against a live fetch); this pass did not run or promote it, since every source the full page needed was already in the standing 2026-09-01 packet — recipe promotion remains open work for a future capture-backfill pass, tracked separately from page depth. Capture-pending: the Bureau of Health Care Quality and Compliance's own complaint and investigation materials; any Nevada Medicaid statement of a reserve-bed or per-diem policy specific to a hospital stay; and any published Bureau statement addressing transfer or discharge directly, unchanged from 2026-09-01. Internet Archive: not yet submitted for this pass. Reviewer: Carrie Schluter, reviewed 2026-09-23. Corrections: hello@fieldassembly.net.
2026-09-01 — Baseline page built from the first Nevada packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Nevada 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) Nevada regulates transfer and discharge from a "facility for skilled nursing" and from a "residential facility for groups" as two distinct, separately defined facility types, and its chapter 449A statute headed "Limitations on transfer or involuntary discharge" (NRS 449A.282), together with its companion notice-content statutes (NRS 449A.284, 449A.286), applies by its own terms only to the latter — a facility type this project's charter places out of v1 scope alongside assisted living. The grounds, notice, and bed-hold provisions that actually govern a skilled-nursing facility sit at NAC 449.74429 and NRS 449A.114 instead, both captured here; NRS 449A.282/.284 are captured only to document the distinction, since a search of NRS chapter 449A for "transfer or discharge" surfaces the out-of-scope sections first. (2) Nevada Medicaid's own reimbursement for reserving a bed is stated only for "therapeutic leave," up to 24 days a year, and its manual expressly excludes hospital stays from that definition ("Therapeutic leave does not include hospital emergency room visits or hospital stays"). Separately, NRS 449.183 and NAC 449.74429(4) require every facility to adopt and disclose its own written policy on how many days it will hold a bed during a hospital stay — but neither states a statewide number, and no Medicaid source found states whether or how a hospital-stay bed-hold is itself reimbursed. (3) Nevada's own regulatory text was recorded here as omitting the possessive apostrophe throughout NAC 449.74429, consistently across the section rather than as an isolated typo; that part of this finding was a capture error and is retracted in the 2026-10-06 entry below; the Medicaid Services Manual's Chapter 3100 omits it once ("the residents request for a Fair Hearing") and then does not ("the resident's request for a Fair Hearing") four paragraphs later, in the Expedited Fair Hearing subsection that otherwise duplicates the Standard subsection's language. Both are preserved as published. (4) The Aging and Disability Services Division's Long-Term Care Ombudsman program page carries a Carson City address of "1550 E College Parkway" in its site footer, while the program's own discharge-rights brochure gives a different Carson City address, "3416 Goni Rd. Suite 132", under the identical phone number, (775) 687-4210. Both are shown; neither is reconciled. (5) The domain printed on Nevada Medicaid's own documents and cited elsewhere, dhcfp.nv.gov, now 301-redirects every path to www.nevadamedicaid.nv.gov; documents were retrieved from the live domain. (6) The current version of the Medicaid Services Manual's Chapter 3100 (Hearings) is dated February 23, 2018 — the site's own chapter-listing page labels it "Current," so this page treats it as Nevada's newest statement of the fair-hearing route notwithstanding its age. (7) NAC 449.74429(2)(b)(7) requires a discharge notice to state a right to appeal but does not name the office; the office (the Division of Health Care Financing and Policy) is named only in a separate Medicaid manual chapter, not in the notice-content rule itself. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-01. Corrections: hello@fieldassembly.net.