Oklahoma

The grounds, as Oklahoma describes them

Three of Oklahoma's own publishers state the grounds differently, and none is used to correct another.

The statute, § 1-1926, "Involuntary Transfer or Discharge of Resident – Grounds" (Oklahoma Nursing Home Care Act, the state's posted copy, retrieved 2026-09-18): "A facility shall not involuntarily transfer or discharge a resident except for medical reasons, for the resident's safety or for the safety of other residents, or for nonpayment for the resident's stay, unless limited by the Federal Social Security Act."

The department's rule, OAC 310:675-7-4(a), "Reasons for transfer or discharge" (OAC 310:675-7-4, the state's posted copy, retrieved 2026-09-18), states the same three grounds with evidentiary conditions attached, in the rule's own order: "Involuntary transfer or discharge of a resident may be initiated by a facility only for one or more of the following:"

1. "Medical reasons, including needs that the facility is unable to meet, as documented by the attending physician, in consultation with the medical director if the medical director and attending physician are not the same person."

2. "The resident's safety, or for the safety of other residents, as documented by the clinical record. The facility shall show through medical records that:" "the resident has had a comprehensive assessment by an interdisciplinary team and alternative measures have been attempted unsuccessfully; or" "the resident is a danger to himself, herself or other resident as documented by the medical record and the facility is not capable of managing that resident."

3) "The non-payment of charges for the resident's care as documented by the facility's business records for services for more than 30 days." (The rule's own numbering drops the opening parenthesis on this third item — "3)" rather than "(3)" — and stands as served.)

A third publisher, the Department of Human Services' consumer leaflet, states a six-item list instead, headed "There are only 6 reasons why a facility can transfer or discharge a resident against their will:" (Nursing Home Transfers & Discharges, retrieved 2026-08-30) — "The facility cannot meet the resident’s needs;" "The resident no longer needs nursing facility services;" "The resident’s presence endangers the safety of others in the facility;" "The resident’s presence endangers the health of others in the facility;" "The resident has failed to pay; or" "The facility is closing." This list reads as the federal enumeration in the leaflet's own words, not as a restatement of the statute's four-clause sentence or the rule's three-item list with subparts. All three are quoted here as each publisher states them; none is treated as authoritative over the others, and the federal enumeration itself stays on the federal page.

The published process

Requesting the hearing

The rule requires the written notice to tell the resident how to appeal, OAC 310:675-7-4(b)(3)(E): "Information that the resident's representative or person responsible for payment of the resident's care who is aggrieved by the facility's decision, may file within ten (10) days of notice a written request for a hearing with the Department by sending a letter to the Hearing Clerk, Oklahoma State Department of Health, 1000 NE Tenth Street, Oklahoma City, OK 73117." A defective notice has a stated consequence rather than a cure period, (b)(4): "Failure of the facility to give the notice as substantially specified above shall result in an order without hearing from the Department denying the right of the facility to discharge the resident."

Once a request is properly filed, (b)(5): "the Department shall convene a hearing within ten working days of receipt of the request. The request may be in the form of a letter or a formal request for hearing from the resident or resident's representative. In the event that the resident is unable to write, a verbal request made to the hearing clerk shall be sufficient. The Department shall reduce the verbal request to writing and send a copy to the resident." Pendency is stated directly, (b)(6): "During the pendency of the hearing, the facility shall not discharge the resident unless the discharge was required by the Department or is an emergency situation. If the resident relocates from the facility but wants to be readmitted, the Department may proceed with the hearing and the facility shall be required to readmit the resident to the first available bed in a semi-private room if the discharge is found not to meet the requirements of the Nursing Home Care Act and OAC 310:675." The decision itself is timed, (b)(13): "The Administrative Law Judge shall render a written decision within ten working days of the close of the record." And the outcome, (b)(14): "If the Administrative Law Judge sustains the facility, the facility may proceed with the discharge. If the Administrative Law Judge finds in favor of the resident, the facility shall withdraw its notice of intent to transfer or discharge the resident. The decision of the Administrative Law Judge shall be final and binding on all parties unless appealed under the Administrative Procedures Act."

The Department of Human Services' leaflet states the same pendency right in its own words: "You have the right to appeal your notice of discharge and remain in the facility pending the outcome of the appeal." and publishes a route to the hearing office by email and phone: "OAH@HEALTH.OK.GOV" and "405-426-8244".

The notice's required contents

OAC 310:675-7-4(b)(3): "The written notice shall include:" "A full explanation of the reasons for the transfer or discharge;" the date of the notice; "The date notice was given to the resident and the resident's representative;" "The date by which the resident must leave the facility;" and the hearing-request information quoted above. A different, shorter clock governs a move to another room within the same facility rather than a transfer or discharge out of it, (c)(1): "If a facility wants to relocate a resident from one room toanother, the facility shall give the resident at least forty-eight hours written notice. The notice shall include the cost of transferring the resident's telephone, if applicable." (The rule's own text runs "toanother" together; it stands as served.) That shorter notice can itself be shortened further with the resident's agreement, (c)(2): "If the resident or the resident's representative agrees in writing to the relocation, the relocation may take place in less than forty-eight hours." And no hearing attaches to a room move the resident agrees to, (c)(3): "No hearing is required if the resident requests or agrees to relocation from one room to another."

Bed-hold and return

The health department's rule addresses readmission after a hospital stay without stating a period in days: OAC 310:675-7-4(b)(2), in part: "The facility shall not use a discharge to a hospital as a reason for failing to re-admit a resident after release from the hospital to the first available bed in a semi-private room. Such action shall be considered to be an involuntary discharge subject to all the requirements of this section, unless the discharge was required by the Department." The Department of Human Services' leaflet states the same right in consumer terms and adds a documentary obligation: "You have the right to return to the facility following hospitalization or therapeutic leave, including the right to return to your bed or the first available bed. The facility must give you information about these rights, as well as a copy of its bed-hold policy in advance of your leave."

A separate publisher, the Oklahoma Health Care Authority — the state Medicaid agency — states the actual period in its own payment rule, and it is not a bed-hold day count in the sense the health department's rule implies but a payment limit. OAC 317:30-5-126, "Therapeutic leave and hospital leave" (OHCA Policy and Rules, the agency's posted copy, retrieved 2026-09-18): "Therapeutic leave is any planned leave other than hospitalization that is for the benefit of the patient. Hospital leave is planned or unplanned leave when the patient is admitted to a licensed hospital. Therapeutic leave must be clearly documented in the patient's plan of care before payment for a reserved bed can be made." On the payment limit, (1): "Effective July 1, 1994, the nursing facility may receive payment for a maximum of seven (7) days of therapeutic leave per calendar year for each recipient to reserve the bed." On hospital leave specifically, (2): "No payment shall be made to a nursing facility for hospital leave." And on how a day counts, (4): "Midnight is the time used to determine whether a patient is present or absent from the facility. The day of discharge for therapeutic leave is counted as the first day of leave, but the day of return from such leave is not counted."

Read together, these are two different things stated by two different publishers and not reconciled here: the health department's rule creates a right to be readmitted to the first available semi-private bed after a hospital stay, stated with no day limit of its own; the Medicaid agency's rule states that Medicaid will not pay to hold a bed during hospital leave at all, and will pay for a reserved bed during non-hospital ("therapeutic") leave for no more than seven days a calendar year. Neither publisher's rule states what happens to a resident's bed, as a matter of the facility's own obligation independent of Medicaid payment, during a hospital stay longer than the department rule's undefined "first available bed" standard would produce in practice. That gap is stated rather than filled from another state or from the federal page.

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

Ten days' notice — statute, § 1-1927: "Involuntary transfer or discharge of a resident from a facility shall be preceded by a minimum written notice of ten (10) days." Two stated exceptions remove the ten-day requirement entirely: an emergency transfer "mandated by the resident's health care needs" under written physician orders, or a transfer "necessary for the physical safety of other residents as documented in the clinical record."

Thirty days' notice — rule, OAC 310:675-7-4(b)(1): "Written notice shall be provided at least thirty (30) days in advance of the transfer or discharge date". The rule's own next paragraph, (b)(2), refers back to "The ten day requirement" for its stated exceptions (an emergency transfer under physician's orders, or a transfer necessary for other residents' physical safety) — the two periods and the cross-reference between them are quoted as published and reconciled nowhere.

Forty-eight hours' notice of a room relocation within the facility — (c)(1): "the facility shall give the resident at least forty-eight hours written notice." — shortenable with written agreement under (c)(2).

Ten days to request a hearing — (b)(3)(E): "may file within ten (10) days of notice a written request for a hearing".

Ten working days for the Department to convene the hearing — (b)(5): "the Department shall convene a hearing within ten working days of receipt of the request."

No discharge while the hearing is pending, with two stated exceptions — (b)(6): "the facility shall not discharge the resident unless the discharge was required by the Department or is an emergency situation."

Ten working days for the Administrative Law Judge's written decision — (b)(13): "within ten working days of the close of the record."

Seven days per calendar year of Medicaid-paid therapeutic-leave bed reservation, and none for hospital leave — OAC 317:30-5-126(1) and (2), quoted above.

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

Source map

Captured: all four, in tools/packets/oklahoma-packet.txt (recipe tools/recipes/oklahoma.json, digest 5f05ccef0701). Pending: official versions of the statute and rule, a first-party ombudsman page from the Attorney General's division, and a first-party statement of a facility-side bed-hold day limit independent of Medicaid payment — per the packet's pending list.

Change log

2026-09-18 — Deepened to a full page. Recaptured the existing recipe (tools/recipes/oklahoma.json): sources 1 through 3 reproduce byte-for-byte against the standing packet, with only the retrieval date changing. Added source 4, OAC 317:30-5-126, the Oklahoma Health Care Authority's own posted copy of its Medicaid therapeutic-leave and hospital-leave payment rule, captured by curl at a CSS scope targeting the specific component holding the rule text (the page's template also carries the same text HTML-escaped inside a client-side analytics attribute, which this capture does not read); the recipe now digests 5f05ccef0701 and the packet was rebuilt and retained (retain-packet.py, result: rebuild). Wrote section 01 (the grounds, quoting all three of Oklahoma's own publishers — the statute's four-clause sentence, the rule's three-item evidentiary list, and the department's consumer leaflet's six-item federal-style list — as a discrepancy, none corrected against another) and section 02 (requesting the hearing, the notice's required contents including the shorter room-relocation clock, bed-hold and return, and the notice-periods register), reusing evidence already standing in the packet for the hearing-office and notice-contents rows. One new source was captured for section 02's bed-hold row, per the calling routine's evidence rules for that row: OAC 317:30-5-126 states that Oklahoma Medicaid pays a nursing facility to hold a bed during non-hospital "therapeutic" leave for a maximum of seven days per calendar year, and states plainly that it pays nothing to hold a bed during a hospital stay. Finding (9): this OHCA payment rule and the health department's own rule at OAC 310:675-7-4(b)(2) state two different things about a hospital-stay bed — the health department's rule creates a readmission right to the first available semi-private bed with no day limit stated, while the Medicaid agency's rule states no payment holds the bed at all during that same stay — and neither publisher states what a facility's own bed-hold obligation is, independent of Medicaid payment, during a hospital stay. That is recorded as a gap rather than filled from either publisher or from another state. Findings, continuing the existing numbering: (10) the room-relocation clock (forty-eight hours, shortenable by written agreement, no hearing where the resident agrees) is a materially shorter and separately-triggered notice than the thirty- or ten-day transfer/discharge clocks, inside the same rule. Capture pending: per the source map above. Internet Archive: not yet submitted for this pass. Reviewer: Carrie Schluter, reviewed 2026-09-18. Corrections: hello@fieldassembly.net.

2026-09-04 — Citation correction: the rule number this page gave the department's transfer and discharge rule was wrong. The docket, the lede and the source map cited OAC 310:675-7-5.1; the rule they quote is OAC 310:675-7-4, Resident transfers or discharge. OAC 310:675-7-5.1 exists in the same chapter and is a different rule — Reports to state and federal agencies, on reporting timelines to the Department. The error was ours, not the state's: it entered with the 2026-08-30 packet, whose header titled the source 310:675-7-5.1, and the page took the label from the packet rather than from the rule heading printed above the text. No quotation changed and no wording changed; every quoted passage on this page was and remains the text of 310:675-7-4, verified against a fresh capture of the state's posted copy before this entry was written, with the thirty-day notice sentence found at 310:675-7-4(b)(1) where the page cites it. The 2026-08-30 entry below is left as it was written, including its finding (1), which carries the same wrong number: corrections here happen on the record rather than by rewriting it. The recipe that now captures this source carries the corrected title, and packets retained before today keep the old one, which is what they said at the time. Reviewer: Carrie Schluter, reviewed 2026-09-04. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Oklahoma packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Oklahoma 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) Oklahoma publishes three different notice periods across its own materials: ten days in the statute at § 1-1927, thirty days in the rule at OAC 310:675-7-5.1(b)(1), and a reference back to "The ten day requirement" in the rule's own next paragraph, which by its terms exempts emergencies from a period the same rule states as thirty. All three are quoted as published and reconciled nowhere. (2) The state's two legal sources both label themselves unofficial in their running feet — the statute copy "copied from OSCN.NET version" dated April 27, 2021, the rule copy "copied from/linked to OAR.STATE.OK.US" dated September 13, 2020. Official versions are capture-pending, and this page quotes the copies the state posts, described as the state describes them. (3) The rule's assembler left a bracketed editorial remark inside the rule text, noting that the OAR website showed two paragraphs lettered d and that this one was changed to c, with a question mark; it stands in the packet as served rather than being removed, and is not quoted here because it nests quotation marks of its own. (4) The statute's grounds are three; the rule's are the same three with evidentiary conditions; the department's consumer leaflet states a six-item federal list. All are quoted on this page as each publisher states them, and the federal enumeration stays on the federal page. (5) Oklahoma states a consequence for a defective notice that few states state: an order without hearing denying the facility the right to discharge. (6) The rule treats a refusal to readmit after a hospital stay as an involuntary discharge subject to the same requirements, unless the discharge was required by the department. (7) The ombudsman contacts here come from a 2022 Department of Human Services leaflet, while the Attorney General's office now lists a Long-Term Care Ombudsman division; the ombudsman row says so, and the division's own page is capture-pending. (8) No first-party statement of an Oklahoma Medicaid 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.