Utah

The grounds, as Utah describes them

R432-150-20(2) states the admission/transfer/discharge rule's own list, in the rule's own order (Utah Administrative Code, effective 02/18/2025, retrieved 2026-09-24): "The licensee shall permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless:"

(a) "the health or safety of an individual in the facility is endangered;"

(b) "the licensee ceases to operate the facility;"

(c) "the resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility;"

(d) "the transfer or discharge is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility; or"

(e) "the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility."

The same current rule states the same right differently in its resident-rights section, R432-150-11(4)(k): a resident has the right to "be transferred or discharged only for: (i) nonpayment for the stay; (ii) personal welfare or welfare of another resident; or (iii) medical reasons" — three items where R432-150-20(2) states five. Both are quoted here as published, in the rule's own order and vocabulary, and neither is reconciled with the other.

The published process

Requesting the hearing

The Division of Aging and Adult Services' own discharge-appeal form states: "If the nursing facility where you live has told you they intend to transfer you or discharge you, and you would rather stay in the facility, you have the right to appeal the facility's decision." and "Appeal requests MUST be turned in within 30 days of the discharge notice." The form is filed with the Office of Administrative Hearings — by mail at "PO Box 143105" "Salt Lake City, UT 84114-3105" or "195 North 1950 West" "Salt Lake City, UT 84116", or by "Fax: 801-536-0143"; the Utah Medicaid Provider Manual gives the same office's email as "EMAIL: utmedicaidhearings@utah.gov".

Utah's Medicaid hearing-procedure rule, R410-14, defines "Action" to include, at R410-14-2(2)(d), "a determination by a skilled nursing facility or nursing facility to transfer or discharge a resident" — one of the rule's enumerated "actions" it governs — and separately provides, at R410-14-23: "Pursuant to 42 CFR 431, Subpart D, DIH shall provide an appeals hearing procedure for SNFs, ICFs or ICF/IDs. The office shall conduct the informal hearing pursuant to this rule and the requirements of 42 CFR 431.153 and 42 CFR 431.154." The rule's general filing deadline, R410-14-5(2)(a), states "a medical assistance provider or member shall request a hearing within 30 calendar days from the date that DIH sends a written notice of agency action" — the same thirty days the discharge-appeal form states.

The pendency provision is at R410-14-6(1): "If the agency mails a notice of agency action in the time required by Section R410-14-3 and the recipient requests a hearing within ten days of the date the notice was mailed, the agency shall continue services until a decision is rendered after the hearing. The agency may terminate or reduce services if it is determined at the hearing that the sole issue is one of federal or state law or policy and the agency promptly informs the recipient in writing that services are to be terminated or reduced pending the hearing decision." R410-14-6(2) states a further reinstatement path: "The agency may reinstate services if a recipient requests a hearing no more than ten days after the date of the action. The reinstated services shall continue until a hearing decision is rendered unless, at the hearing, it is determined that the sole issue is one of federal or state law or policy." Neither R432-150 nor the discharge-appeal form itself states a pendency provision in those terms; R410-14-6 is the only first-party Utah statement located addressing continuation while an appeal is pending, and it is quoted here as the rule states it, without determining whether it applies to any particular facility-initiated transfer or discharge.

The notice's required contents

Before a transfer or discharge, R432-150-20(6) requires the licensee to ensure "a written notification of the transfer or discharge and the reasons for the transfer or discharge to the resident is provided in a language and manner the resident understands, and, if known, to a family member or legal representative of the resident" and that the notice includes "the effective date of transfer or discharge;" "the location where the resident is transferred or discharged;" "the name, address, and telephone number of the state and local long term care ombudsman programs;" and "the reason for transfer or discharge" (R432-150-20(6)). A notice to a resident with a developmental disability or mental illness must separately carry "the mailing address and telephone number of the Disability Law Center" (R432-150-20(7)(c)-(d)).

Bed-hold and return

R432-150-20(9) requires a facility to maintain "a written policy" on readmission after a bed-hold period, to notify the resident and family that "notification is provided as soon as possible following a transfer necessitated by a medical emergency;" and to specify in writing "the duration of the bed-hold policy at the time of transfer of a resident to a hospital or for therapeutic leave" — but the rule sets no state-wide number of bed-hold days; the duration is left to each facility's own written policy. Two further first-party Medicaid sources were searched for a state-set bed-hold period and neither states one: the Utah Medicaid Provider Manual's chapter 5-4, Hearings and Administrative Review, addresses only the hearing process and does not address bed-hold; and R414-504, Nursing Facility Payments — the Medicaid rule governing nursing-facility reimbursement, including "swing beds, transitional care unit beds, and small health care facility beds that are used as nursing facility beds" (R414-504-3(9)) — addresses payment methodology and case-mix rates, not a bed-hold or reserved-bed day count. No first-party Utah source stating a fixed, state-wide bed-hold period was located in this pass; the Medicaid Provider Manual's chapter on physical disabilities, not yet reachable (see change log), remains unsearched.

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Utah'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, with four exceptions — R432-150-20(7)(a)-(b): the notice is due "at least 30 days before the resident is transferred or discharged" except that the licensee "may issue the notice of transfer or discharge as soon as practicable" where "a resident has not resided in the facility for 30 days" or "an immediate transfer or discharge is required by the resident's urgent medical needs" or "the resident's health improves sufficiently to allow a more immediate transfer or discharge" or "the safety or health of individuals in the facility would be endangered if the resident is not transferred or discharged sooner."

Thirty days to appeal — the discharge-appeal form: "Appeal requests MUST be turned in within 30 days of the discharge notice"; R410-14-5(2)(a) states the same period for the general Medicaid hearing route: "a medical assistance provider or member shall request a hearing within 30 calendar days from the date that DIH sends a written notice of agency action."

Ten days for continued services while the appeal is pending — R410-14-6(1), quoted in full in section 02.

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

Source map

Captured: nine quotable documents, plus three rule-metadata version witnesses (for R432-150, R410-14, and R414-504) that this page does not quote, all in tools/packets/utah-packet.txt. Pending: the Medicaid Provider Manual's chapter on physical disabilities (unreachable — see 2026-09-01 change log entry), any Utah Code section establishing the Long-Term Care Ombudsman program by statute, and any first-party statement of a specific Medicaid bed-hold day count (R414-504, Nursing Facility Payments, was captured and searched for one on 2026-09-24 without result — see change log).

Change log

2026-09-24 — Deepened to a full page: sections 01 and 02 written, and R432-150-20(9)'s bed-hold absence searched further. Transport: recipe re-run (curl, browser user-agent, unchanged from the 2026-09-04 transports) plus two new first-party sources reached the same way as the existing R432-150 capture (adminrules.utah.gov's own getHTML endpoint, GUID-pinned, with a rule-number-keyed metadata witness for each). New sources: R410-14, Administrative Hearing Procedures (recipe sources 9-10), and R414-504, Nursing Facility Payments (sources 11-12); R410-14 was located because the already-captured Provider Manual (source 5) itself names it as the rule setting forth Medicaid hearing procedures, and R414-504 was located as the Medicaid rule most likely to state a bed-hold day count, following the trail from R432-150-20(9)'s facility-level bed-hold policy requirement. Findings: (1) R410-14-2(2)(d) defines a nursing facility's own determination to transfer or discharge a resident as an "action" the rule governs, and R410-14-23 names an SNF appeals procedure under 42 CFR 431 Subpart D directly; neither cross-reference had been captured before this pass. (2) R410-14-6(1) is a pendency provision — continuation of services where a hearing is requested within ten days of a mailed notice of agency action — and is the only first-party Utah statement located addressing whether services continue while an appeal is pending; R432-150 and the discharge-appeal form state none. (3) R414-504, the Medicaid nursing-facility payment rule, was searched for a state-wide bed-hold day count and states none; it addresses case-mix reimbursement and separately reimburses "swing beds, transitional care unit beds, and small health care facility beds that are used as nursing facility beds" (R414-504-3(9)) by a statewide average rate, which is a payment provision, not a bed-hold duration. The absence recorded 2026-09-01 stands, now searched against one more first-party source. (4) Recapturing the standing packet surfaced an unrelated, incidental source change: the Utah Medicaid Provider Manual chapter (source 5) now carries a "Updated September 2026" footer where the 2026-09-04 capture read "Updated July 2026"; every quotation this page draws from that chapter appears verbatim in the September text, so this is the same chapter under routine revision, not a substantive change, and the source map and recipe now record the current date. Both pages check at zero failures against the twelve-source recipe-driven capture. Reviewer: Carrie Schluter, reviewed 2026-09-24. Corrections: hello@fieldassembly.net.

2026-09-04 — Capture recipe written; two sources re-based and the browser transport retired. Utah had no recipe, so nothing had re-fetched its sources since 2026-09-01 and two of them had moved without anything noticing. The skilled nursing facility discharge appeal form was renamed in place by the department, from SNF-Discharge-Appeal-Form.pdf to SNF-Discharge-Appeal-Form-11.7.23.pdf, and its old address now returns a bare 404; it was found again by reading the Long Term Care Ombudsman page, which still links it. The Ombudsman Locations page 301-redirects to a new address. Both were verified before re-basing rather than assumed: every quotation this page draws from the appeal form, and every quotation it draws from R432-150, appears verbatim in the documents now served, so these are the same instruments under new addresses and not new documents. Findings: (1) R432-150 has not moved and was never missing. adminrules.utah.gov is a client-rendered application whose rule addresses return 404 to any direct fetch, which the 2026-09-01 capture had already recorded; a re-check on 2026-09-04 first reported it as a dead address, and that was wrong. The rule is captured from the address the application itself fetches, which is first-party and reachable. (2) that address names a version rather than the rule: it carries a GUID, and an amendment would produce a new one while the old kept returning the superseded text and every check kept passing. The packet therefore also carries the rule-number-keyed metadata the application uses, as source 8, purely as a version witness — it holds the effective date and the current GUID, so an amendment changes this packet, the review pass reports drift, and a session updates the pinned address deliberately. It is not a source this page quotes. (3) sources 3, 4, 6 and 7 no longer need a browser. The 2026-09-01 capture had to render four pages and read them from the DOM because Cloudflare hid every address behind a client-side script, recorded then as a last-resort transport that an automated pass could not re-verify; decode_cfemail resolves them under curl, so the whole state is now capturable mechanically. The four placeholders in the standing packet are gone and the addresses the departments publish — utmedicaidhearings@utah.gov, agingservices@utah.gov and the regional ombudsman roster — are in the evidence this page rests on. (4) source 5 is now pinned to printed pages 55 to 57 rather than hand-sliced from a 139-page manual; the chapter heading also appears on pages 4 and 134, in the contents and a cross-reference, so the range is pinned rather than searched for. No quotation on this page changed. Both pages check at zero failures against the recipe-driven capture. Reviewer: Carrie Schluter, reviewed 2026-09-04. Corrections: hello@fieldassembly.net.

2026-09-01 — Baseline page built from the first Utah packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Utah 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). Transports: R432-150 was rendered in a browser (rules.utah.gov redirects to a JavaScript single-page app at adminrules.utah.gov that returns 404 to curl and to the session fetch tool); the discharge-appeal form and the Provider Manual chapter were retrieved by curl and read with pdftotext -layout; the two hearings pages and the two ombudsman pages were retrieved by curl, and the ombudsman pages were additionally rendered in a browser to resolve their Cloudflare-obfuscated contact emails to plain text. Findings: (1) R432-150 states the grounds twice and differently within the same current rule — five circumstances in the admission/transfer/discharge section (R432-150-20(2)) and three in the resident-rights section (R432-150-11(4)(k)); both are quoted as published and neither is reconciled here. (2) The licensing rule, R432-150, names no hearing office, filing address, or deadline for a facility-initiated transfer or discharge; the appeal route that exists — a 30-day filing with the Office of Administrative Hearings — is published instead by the Division of Aging and Adult Services' own discharge-appeal form and confirmed by the department's general Medicaid-hearings pages. (3) Those general hearings pages (medicaid.utah.gov/hearings and dhhs.utah.gov/oah/medicaid-fair-hearings) state the Office of Administrative Hearings' street address with zip code 84111; the discharge-appeal form and the Provider Manual state the same street address with zip code 84116. Both are quoted as published and not reconciled. (4) R432-150-20(9) requires each facility to have its own written bed-hold policy and to disclose its duration to the resident and family at the time of a hospital transfer, but the rule sets no state-wide number of days; no first-party Utah source stating a fixed bed-hold period was located. (5) The Utah Medicaid Provider Manual's chapter on physical disabilities, which a search-engine summary described as addressing bed-hold non-payment, could not be captured: medicaid-manuals.dhhs.utah.gov failed to resolve by hostname from curl, the session fetch tool, and the browser tool alike on 2026-09-01. This is a transport failure, not a finding about the chapter's content, and it is not treated as an absence. (6) A resource manual on facility-initiated transfers and discharges, linked from the Long Term Care Ombudsman page and hosted on daas.utah.gov, states on its own face that it was "developed by the National Consumer Voice for Quality Long-Term Care, in coordination with the Utah Office of the State Long-Term Care Ombudsman" — co-authored by a national advocacy organization — and was excluded from the packet on that basis, per CHARTER.md's bar on third-party guides and advocacy summaries, notwithstanding that the department hosts and links it. (7) R432-150-20(7)(a) cites "Subsection R432-150-21(6)(a)" and "Subsection R432-150-(21)(4)" for its own notice-timing exceptions; R432-150-21 in the current rule is titled "Ancillary Health Services" and does not appear to contain those subsections — quoted here exactly as the rule states it, with no correction attempted. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-09-01. Corrections: hello@fieldassembly.net.