Virginia

The grounds, as Virginia describes them

§ 32.1-138.1(A) of the Code of Virginia: "To implement and conform with the provisions of subdivision A 4 of § 32.1-138, a facility may discharge the patient, or transfer the patient, including transfer within the facility, only:"

1. "If appropriate to meet that patient's documented medical needs;"

2. "If appropriate to safeguard that patient or one or more other patients from physical or emotional injury;"

3. "On account of nonpayment for his stay except as prohibited by Titles XVIII or XIX of the United States Social Security Act and the Virginia State Plan for Medical Assistance Services; or"

4. "With the informed voluntary consent of the patient, or if incapable of providing consent, with the informed voluntary consent of the patient's authorized decision maker pursuant to § 54.1-2986 acting in the best interest of the patient, following reasonable advance written notice."

§ 32.1-138(A)(5) states the same ground among the enumerated patients' rights, more briefly, as the right to be "transferred or discharged only for medical reasons, or for his welfare or that of other patients, or for nonpayment for his stay except as prohibited by Titles XVIII or XIX of the United States Social Security Act, and is given reasonable advance notice as provided in § 32.1-138.1 to ensure orderly transfer or discharge, and such actions are documented in his medical record".

DMAS's own Nursing Home Manual, in the same chapter that states the notice and bed-hold provisions quoted in section 02, separately restates a six-part list before turning to Virginia's own statute: the nursing home "must permit each resident to remain in the nursing home and not transfer or discharge unless" the transfer or discharge is "necessary for the resident's welfare, and the resident's needs cannot be met in the nursing home"; is "appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the nursing home"; "The safety of individuals in the nursing home is endangered"; "The health of individuals in the nursing home would otherwise be endangered"; the resident "has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the nursing home"; or "The facility ceases to operate." The manual introduces this list as coming from "the federal requirements" and immediately follows it with a separate heading, "In addition to the federal requirements above regarding transfer and discharge, nursing home should also note the requirements of subsection B of §32.1-138 of the Code of Virginia", before quoting § 32.1-138.1 again. DMAS's manual therefore presents two ground lists side by side without merging them — see the change log finding.

The published process

Requesting the hearing

The DMAS Appeals Division's own FAQ states its jurisdiction: "The DMAS Appeals Division also hears appeals related to actions for services provided by a nursing facility, in accordance with § 1919(b)(3)(F) or 1919(e)(7)(B) of the Social Security Act", and separately, among appealable actions, "A determination made by a nursing facility to transfer or discharge a resident". Filing route: "The Virginia Department of Medical Assistance Services (DMAS) has a portal to make it easier for you to file an appeal. The portal is called the Appeals Information Management System (AIMS)." "While DMAS encourages you to use the AIMS portal, we will continue to accept appeals by email, fax, mail and phone", at "appeals@dmas.virginia.gov" and "(804) 452-5454", with a fax number and street address published alongside.

On a filing deadline, the same document states, for Medicaid and FAMIS appeals generally: "Is there a time limit for filing an appeal? Yes, the time limit for filing an appeal is noted on the written notice of action from the agency. In most cases, the time limit is 30 days from the date you receive the written notice of action from the agency." On pendency, the same document states: "You may request to have your coverage continued during the appeal process if you file your appeal request before the date coverage is terminated or within 10 days of the date stated on the notice of action you are appealing. This is known as continued coverage." Neither passage is stated by DMAS to govern a nursing facility's own transfer or discharge notice as opposed to a notice of action issued by the agency itself, and the document does not separately state a filing deadline or a pendency provision for a nursing facility discharge appeal; the absence at that scope is recorded as a finding in the change log, not filled from the general Medicaid language quoted above.

The notice's required contents

DMAS's Nursing Home Manual: "Before a nursing home transfers or discharges a resident, the nursing home must 1) notify the resident and, if known, a family member or legal representative of the resident of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand; 2) record the reasons in the resident's clinical record; and 3) include in the notice the items described in (a) through (f) above." "The written notice must include a) the reason for the transfer or discharge, b) the effective date of the transfer or discharge, c) the location to which the resident is transferred or discharged; and d) a statement that the resident has the right to appeal the action to the state. The notice must also include the name, address, and telephone number of the State Long-Term Care Ombudsman. For nursing home residents with developmental disabilities or mental illness, the notice must include the mailing address and telephone number of the Department for Rights of Virginians with Disabilities."

No Virginia source captured states a requirement, separate from the above, that the notice describe the manner of requesting a hearing or carry a hearing deadline; the absence at that scope is recorded in the change log.

Bed-hold and return

DMAS's Nursing Home Manual: "Notice of Bed-Hold Policy and Readmission: Before a nursing home transfers a resident to a hospital or allows a resident to go on therapeutic leave, the nursing home must provide written information to the resident and a family member or legal representative that specifies: 1) the duration of the bed-hold policy under the State Plan for Medical Assistance, if any, during which the resident is permitted to return and resume residence in the facility; and 2) the facility's policies regarding bed-hold periods following hospitalization or therapeutic leave, permitting a resident to return." "At the time of transfer of a resident for hospitalization or therapeutic leave, a nursing home must provide to the resident and a family member or legal representative written notice which specifies the duration of the bed-hold policy. A nursing home must establish and follow a written policy under which a resident, whose hospitalization or therapeutic leave" "exceeds the bed-hold period under the State Plan for Medical Assistance, is readmitted to the nursing home immediately upon the first availability of a bed in a semi-private room if the resident: 1) requires the services provided by the nursing home, and 2) is eligible for Medicaid nursing home services." A page break in the served PDF falls between "therapeutic leave" and "exceeds the bed-hold period"; the two quotations above are adjacent spans of the same sentence, split at that artifact rather than bridged across it.

A separate section of the same manual, addressing patient-pay adjustments rather than the bed-hold notice, states: "DMAS will not pay to hold a Medicaid recipient's bed when the recipient is admitted to the hospital. Bed-hold days are not considered medically necessary and are not approved when requested on DMAS-122 adjustments." The manual does not reconcile this sentence with the bed-hold policy it describes elsewhere in the same document, and this page does not reconcile it either; both are quoted as a numbered finding in the change log. No first-party statement of a specific number of bed-hold days under Virginia's State Plan for Medical Assistance was captured; the manual describes the notice a facility must give of "the duration of the bed-hold policy" without stating that duration itself in the text reviewed.

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

Five days' advance notice for an involuntary transfer or discharge — § 32.1-138.1(C): "In the case of an involuntary transfer or discharge, reasonable advance written notice shall be given to the patient at least five days prior to the discharge or transfer."

Thirty days' advance notice, DMAS's own manual — restating a distinct standard from the same document: "The notification must be made by the nursing home at least 30 days before the resident is transferred or discharged", with notice made "as soon as is practicable" in five stated circumstances, including "A resident has not resided in the nursing home for 30 days." This page does not reconcile the statute's five-day period with the manual's thirty-day restatement; both are quoted, and the discrepancy is recorded as a finding in the change log.

Thirty days, general Medicaid appeal deadline — the DMAS Appeals Division FAQ, quoted in full above: "In most cases, the time limit is 30 days from the date you receive the written notice of action from the agency." Stated for Medicaid and FAMIS appeals generally, and not stated to apply specifically to a nursing facility discharge notice.

Ten days, general Medicaid continued-coverage request — the same FAQ, quoted in full above: coverage may continue if the appeal is filed "before the date coverage is terminated or within 10 days of the date stated on the notice of action you are appealing." Again stated for Medicaid and FAMIS actions generally, and not stated to apply specifically to a nursing facility discharge notice.

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

Source map

Captured: all four, in tools/packets/virginia-packet.txt. Pending: 12VAC5-371 (Virginia's nursing facility licensure regulation, checked 2026-09-15 at 12VAC5-371-150 and found to add no transfer/discharge/bed-hold text beyond cross-referencing §§ 32.1-138 and 32.1-138.1), a statewide ombudsman contact, and the specific number of bed-hold days under Virginia's State Plan for Medical Assistance, per the change log.

Change log

2026-09-25 — Correction: broken source-map link. The link to DMAS's Nursing Home Manual, Chapter VII returned HTTP 404 to every reader since it was added on 2026-09-15. The document never moved: its file name contains parentheses, and this site's own renderer ended the link at the first closing parenthesis, so the published link stopped at "(Nursing%20Facilities" and dropped ".pdf". That was our error, not the publisher's. The link now carries the same address with its parentheses percent-encoded (%28, %29), which DMAS serves identically. All four sources were re-captured through the standing recipe (tools/recipes/virginia.json, recipe c974353f8613) the same day; the chapter's text is unchanged from the 2026-09-15 capture, and both the working page and the published page verify at zero failures against the new capture, which was retained and promoted. No wording on this page changed. Reviewer: Carrie Schluter, reviewed 2026-09-25. Corrections: hello@fieldassembly.net.

2026-09-15 — Deepened to a full page. Captured, by curl with a browser user-agent through the existing recipe (tools/recipes/virginia.json, recipe c974353f8613): a fourth source, DMAS's Nursing Home Manual, Chapter VII (Residents' Rights and Responsibilities), extracted with pdftotext-layout. Sources 1 through 3 were recaptured unchanged through the standing recipe; source 1's known footer-block variability recurred (287-character range previously documented) with no change to the statutory text. Wrote section 01 (the grounds, as Virginia describes them) and section 02 (the published process: requesting the hearing, the notice's required contents, bed-hold and return, and the notice-periods register). Findings, continuing the baseline page's numbering: (1) Virginia's advance notice is five days under § 32.1-138.1(C); no thirty-day period appears in the Code of Virginia sources. (2) Section 32.1-138.1 opens by stating it implements "subdivision A 4 of § 32.1-138", but the transfer and discharge right as published sits at subdivision A 5; reproduced as published and reconciled nowhere. (3) The notice's required contents are now stated: DMAS's manual lists the reason, effective date, relocation location, appeal-rights statement, and the ombudsman's name, address, and telephone number; no requirement that the notice describe the manner of requesting a hearing is stated. (4) DMAS names nursing facility discharge among the actions it hears and cites the federal statute for that jurisdiction, but its FAQ's stated filing deadline (30 days) and continued-coverage window (10 days) are stated for Medicaid and FAMIS agency actions generally, not specifically for a nursing facility's own discharge notice; no facility-discharge-specific deadline or pendency provision was found in the sources reviewed. (5) The Department for Aging and Rehabilitative Services publishes no statewide ombudsman telephone number on the page captured — only a locator and the department's own general number. (6) New: DMAS's manual states a thirty-day advance-notice standard ("at least 30 days before the resident is transferred or discharged") in the same chapter that separately restates § 32.1-138.1's five-day standard; both are quoted in section 02, and the discrepancy is not reconciled. (7) New: the same manual presents a six-part "federal requirements" ground list immediately followed by its own restatement of § 32.1-138.1's narrower three-ground list, under an "In addition to the federal requirements above" heading; both are quoted in section 01 without merging. (8) New: the manual's bed-hold section describes the notice a facility must give of "the duration of the bed-hold policy" without stating that duration, while a separate section of the same document, addressing DMAS-122 patient-pay adjustments, states that DMAS will not pay to hold a bed during a hospital admission; both are quoted in section 02, unreconciled. (9) 12VAC5-371-150 (Resident rights), the state's nursing facility licensure regulation, was checked and adds no transfer, discharge, notice, or bed-hold text beyond certifying compliance with §§ 32.1-138 and 32.1-138.1; it is not quoted as a distinct source of the grounds or the process. Capture-pending: a statewide ombudsman telephone number, and a first-party statement of the specific number of bed-hold days under Virginia's State Plan for Medical Assistance, per the source map. Recipe: tools/recipes/virginia.json extended with source 4; digest changed from 6d663b74240c to c974353f8613. Internet Archive: not yet submitted for the new source. Reviewer: Carrie Schluter, reviewed 2026-09-15. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Virginia packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Virginia describes them) and section 02 (the published process, including the notice's required contents, bed-hold and return, and the notice-periods register). Findings: (1) Virginia's advance notice is five days, and the statute frames it as "reasonable advance written notice" with that minimum; no thirty-day period appears anywhere in the captured Virginia sources, and none is supplied from federal law. (2) Section 32.1-138.1 opens by stating that it implements "subdivision A 4 of § 32.1-138", but the transfer and discharge right in the section as published sits at subdivision A 5, and subdivision A 4 concerns being informed of one's medical condition; the cross-reference is reproduced as published and reconciled nowhere. (3) No Virginia source captured states what the written notice must contain — the statute states when notice is given and who must be consulted, not what the notice says. The absence is stated rather than filled from federal law. (4) DMAS names nursing facility discharge among the actions it hears and cites the federal statute for that jurisdiction, but publishes no filing deadline specific to these appeals; the general Medicaid appeal deadlines in the same document are stated for agency actions on eligibility and services, and this page does not assume they apply. (5) The Department for Aging and Rehabilitative Services publishes no statewide ombudsman telephone number on the page captured — only a locator and the department's own general number — so the ombudsman row states what the department publishes. (6) No first-party statement of a Virginia 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.