Washington
- Grounds stated in the sources
- RCW 74.42.450(3) states four: "A resident shall be transferred or discharged only for medical reasons, the resident's welfare or request, the welfare of other residents, or nonpayment. A resident may not be discharged for nonpayment if the discharge would be prohibited by the medicaid program." WAC 388-97-0120(1) states six, and requires the facility to comply with the federal rules and the statute together: a move may not happen unless "At the resident's request;", "The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;", the resident's health has improved enough that the facility's services are no longer needed, "The safety of individuals in the facility is endangered;", "The health of individuals in the facility would otherwise be endangered; or" the resident has failed, after reasonable and appropriate notice, to pay. Before any of it, the facility "must first attempt through reasonable accommodations to avoid the transfer or discharge unless the transfer or discharge is agreed to by the resident."
- Notice stated in the sources
- Washington runs two periods, split by the kind of facility. The rule requires the notice to "Be provided 30 days in advance of a transfer or discharge initiated by the nursing facility, except that the notice may be given as soon as practicable when the facility cannot meet the resident's urgent medical needs", and to "Be provided 15 days in advance of a transfer or discharge initiated by the nursing home, unless the transfer is an emergency." It must "Be in writing, in language the resident understands;" and be given to the resident, the surrogate decision maker, the family "and to the department". Where the department itself decides a resident no longer needs nursing facility care, the statute requires thirty days' written notice and states: "A form for requesting a hearing to appeal the discharge decision shall be attached to the written notice." That notice must state the reason, "A statement that the resident has the right to appeal the discharge; and" the name, address and telephone number of the state long-term care ombuds.
- Hearing office in these sources
- Stated only for a department decision, and by statute as an effect rather than an address: under RCW 74.42.450(6), where the resident appeals a department discharge decision, "the resident shall not be discharged without the resident's consent until at least thirty days after a final order is entered upholding the decision to discharge the resident." The statute attaches the hearing-request form to the notice and names no office. Neither RCW 74.42.450 nor WAC 388-97-0120 cites it, but chapter 388-02 WAC is DSHS's own general hearing-procedure chapter — it "Regulates all hearings involving DSHS" while noting "Specific DSHS program hearing rules prevail over the rules in this chapter." (WAC 388-02-0005) — and states the Office of Administrative Hearings' address: "Office of Administrative Hearings" "2420 Bristol Court SW" "P.O. Box 42488" "Olympia WA 98504-2488" "(360) 407-2700" (WAC 388-02-0025), with a written request sent "to the location on the notice or to OAH at the location specified in WAC 388-02-0025(2)." (WAC 388-02-0100). No captured source states a forum, a deadline or an address for appealing a facility-initiated transfer or discharge. What the rule states instead is where the facility's notice must be copied: to "The department's home and community services" where the resident's health has improved, and to "The department's designated local office" where the move is for unmet needs, endangerment, or nonpayment.
- Ombudsman in these sources
- The Washington State Long-Term Care Ombudsman Program, whose published contacts are "ltcop@mschelps.org", "1-800-562-6028", "Fax: 253-815-8173", "TTY Number: 711" and "1200 S. 336th St, Federal Way, WA 98003". The programme also names a separate legal service: "Legal Counsel for Long-Term Care Office of Civil Legal Aid The new legal services program for Medicaid residents who are facing discharge or eviction from a community based care setting." at "(888) 437-0017".
- Sources last checked
- Oct 17, 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 Washington's own publishers state about transfer and discharge from a nursing facility or nursing home. Two sources carry nearly all of it — RCW 74.42.450 and WAC 388-97-0120 — and they are best read together, because the rule opens by requiring compliance with the federal regulations and the statute at once, and then adds Washington's own terms on top. Washington's vocabulary distinguishes a nursing facility from a nursing home, and the distinction is not cosmetic: it sets the notice period.
Two features stand out. The reasonable-accommodation duty in subsection (7) comes before the grounds rather than after them — the facility must first try to avoid the move, and may admit or retain only those it can safely serve with available staff or through accommodations required by federal or state antidiscrimination law. And the appeal machinery Washington states in statute is built for a department decision that a resident no longer needs nursing facility care, not for a facility's own decision to discharge: it is that notice which carries the hearing-request form, and that appeal which holds the move for thirty days past a final order. 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 Washington describes them
RCW 74.42.450(3): "A resident shall be transferred or discharged only for medical reasons, the resident's welfare or request, the welfare of other residents, or nonpayment. A resident may not be discharged for nonpayment if the discharge would be prohibited by the medicaid program."
WAC 388-97-0120(1) states six, reached by requiring compliance with both the federal regulation and the statute at once: "The skilled nursing facility and nursing facility must comply with all of the requirements of 42 C.F.R. § 483.10 and § 483.12, and RCW 74.42.450, or successor laws, and the nursing home must comply with all of the requirements of RCW 74.42.450 (1) through (4) and (7), or successor laws, including the following provisions and must not transfer or discharge any resident unless:" in the rule's own order:
"At the resident's request;"
"The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;"
"The transfer or discharge is appropriate because the resident's health has improved enough so the resident no longer needs the services provided by the facility;"
"The safety of individuals in the facility is endangered;"
"The health of individuals in the facility would otherwise be endangered; or"
"The resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility."
Before any of it, the rule states a duty that precedes the grounds rather than following them. The statute: "Before the facility transfers or discharges a resident, the facility must first attempt through reasonable accommodations to avoid the transfer or discharge unless the transfer or discharge is agreed to by the resident. The facility shall admit or retain only individuals whose needs it can safely and appropriately serve in the facility with available staff or through the provision of reasonable accommodations required by state or federal law." and defines the term: "Reasonable accommodations" "has the meaning given to this term under the federal Americans with disabilities act of 1990, 42 U.S.C. Sec. 12101 et seq. and other applicable federal or state antidiscrimination laws and regulations." (RCW 74.42.450(7)). The rule restates the same duty for the nursing-home side of the distinction: the nursing home must "Attempt to avoid the transfer or discharge of a resident from the nursing home through the use of reasonable accommodations unless agreed to by the resident and the requirements of WAC 388-97-0080 are met" (WAC 388-97-0120(3)(b)).
The published process
Requesting the hearing
Washington states an appeal route in statute only for a discharge decision the department itself makes, not for a facility's own decision to transfer or discharge a resident. Where "the department determines that a resident no longer requires a nursing facility level of care, the resident shall not be discharged from the nursing facility until at least thirty days after written notice is given to the resident, the resident's surrogate decision maker and, if appropriate, a family member or the resident's representative." and "A form for requesting a hearing to appeal the discharge decision shall be attached to the written notice." (RCW 74.42.450(5)). The statute names no office to which that form is sent.
Pendency, stated for that same department decision: "If the resident appeals a department discharge decision, the resident shall not be discharged without the resident's consent until at least thirty days after a final order is entered upholding the decision to discharge the resident." (RCW 74.42.450(6)).
Neither RCW 74.42.450 nor WAC 388-97-0120 cites a hearing-procedure chapter by number. Chapter 388-02 WAC is the Department of Social and Health Services' own general hearing chapter: it states that it "Regulates all hearings involving DSHS" and "Consolidates most DSHS hearing procedural rules into one chapter." while also stating that "Specific DSHS program hearing rules prevail over the rules in this chapter." (WAC 388-02-0005). On that chapter's own terms, it states the Office of Administrative Hearings' headquarters as "Office of Administrative Hearings" "2420 Bristol Court SW" "P.O. Box 42488" "Olympia WA 98504-2488" "(360) 407-2700" "(360) 664-8721 (fax)", field offices in Olympia, Seattle, Spokane Valley and Tacoma, and a call center at "(360) 407-2700" toll free at "(800) 583-8271" (WAC 388-02-0025). A request may be made "in writing or orally, depending upon which program is involved." and "The DSHS notice and applicable laws and rules should tell you whether the request must be in writing or may be made orally"; a written request may go "by mail, delivery service, personal service, or by fax if you mail a copy the same day." sent "to the location on the notice or to OAH at the location specified in WAC 388-02-0025(2)." (WAC 388-02-0100). This page treats chapter 388-02 as Washington's general hearing route on the strength of its own stated scope — it "Regulates all hearings involving DSHS" — not because either RCW 74.42.450 or WAC 388-97-0120 names it, and the chapter itself states that a more specific DSHS program rule would control if one exists.
On a filing deadline, chapter 388-02 states only that "The deadline for your request varies by the DSHS program involved." (WAC 388-02-0085). The one specific number the chapter states — that "if an applicant or recipient does not file a request for a hearing within 90 calendar days after receiving notice of an aggrieving decision, the request may still be filed within one year of the aggrieving decision upon a showing of good cause" — is scoped to "public assistance cases, as defined in RCW 74.08.080" (WAC 388-02-0085), a different program, and is not carried here as a nursing-facility figure.
No captured source states a forum, a deadline, or an address for appealing a facility-initiated transfer or discharge under WAC 388-97-0120 specifically. That absence is stated here rather than assumed to be filled by chapter 388-02's general route.
The notice's required contents
For a nursing home or nursing facility's own notice, WAC 388-97-0120(2): the notice must "Include all information required by 42 C.F.R. § 483.12 when given in a nursing facility;" "Be in writing, in language the resident understands;" and "Be given to the resident, the resident's surrogate decision maker, if any, the resident's family, and to the department". No further Washington-specific contents beyond the federal cross-reference are stated for this notice.
For a department discharge notice, RCW 74.42.450(5) states more: "The written notice shall include at least the following:" "The reason for the discharge;" "A statement that the resident has the right to appeal the discharge; and" "The name, address, and telephone number of the state long-term care ombuds."
The rule also states where a facility's notice must be copied, depending on the reason for the move: "The department's home and community services when the nursing home has determined under WAC 388-97-0100, that the medicaid resident's health has improved sufficiently so that the resident no longer needs the services provided by the facility;" and "The department's designated local office when the transfer or discharge is for any of the following reasons:" "The resident's needs cannot be met in the facility;" "The health or safety of individuals in the facility is endangered; or" "The resident has failed to pay for, or to have paid under medicare or medicaid, a stay at the facility." (WAC 388-97-0120(5)).
Bed-hold and return
WAC 388-97-0120 states a duty to have and disclose a bed-hold policy, not a state-set number of days for every kind of leave. The nursing home must "Develop and implement a bed-hold policy. This policy must be consistent with any bed-hold policy that the department develops." (WAC 388-97-0120(3)(c)), and must provide it in writing before a transfer or leave begins: "The nursing home must provide the bed-hold policy, in written format, to the resident, and a family member, before the resident is transferred or goes on therapeutic leave. At a minimum the policy must state:" "The number of days, if any, the nursing home will hold a resident's bed pending return from hospitalization or social/therapeutic leave;" and "That a medicaid eligible resident, whose hospitalization or social/therapeutic leave exceeds the maximum number of bed-hold days will be readmitted to the first available semi-private bed, provided the resident needs nursing facility services." A medicaid-eligible resident "may be charged if they request that a specific bed be held, but may not be charged a bed-hold fee for the right to return to the first available bed in a semi-private room." (WAC 388-97-0120(4)).
For social or therapeutic leave specifically, Washington Medicaid states a number: "The department will pay the nursing facility for a medicaid resident's social/therapeutic leave not to exceed a total of eighteen days per calendar year per resident." (WAC 388-97-0160(3)), extendable — "The department's home and community services may authorize social/therapeutic leave exceeding eighteen days per calendar year per resident when requested by the nursing facility or by the resident. In the absence of prior authorization from the department's home and community services, the department will not make payment to a nursing facility for leave days exceeding eighteen per calendar year per resident." (WAC 388-97-0160(4)). "An individual who is on social/therapeutic leave retains the status of a nursing facility resident." (WAC 388-97-0160(5)).
No separate first-party statement of a hospitalization-specific bed-hold day count was located in the Medicaid rules reviewed (WAC 388-97-0120, WAC 388-97-0160, and the department's cost-related payment chapter, WAC 388-96). WAC 388-97-0120(4)(a) leaves that number to each nursing home's own disclosed policy rather than setting one itself. That absence is stated here rather than filled from the eighteen-day social/therapeutic figure, which the rule states only for social or therapeutic leave.
The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Washington'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, nursing facility notice — WAC 388-97-0120(2)(d): the notice must "Be provided 30 days in advance of a transfer or discharge initiated by the nursing facility, except that the notice may be given as soon as practicable when the facility cannot meet the resident's urgent medical needs, or under the conditions described in (1)(c), (d), and (e) of this section".
Fifteen days, nursing home notice — WAC 388-97-0120(2)(e): the notice must "Be provided 15 days in advance of a transfer or discharge initiated by the nursing home, unless the transfer is an emergency."
Fifteen days, transfer to a hospital or other facility — RCW 74.42.450(2): "The resident, the resident's guardian, if any, the resident's next of kin, the attending physician, and the department shall be consulted at least fifteen days before a transfer or discharge unless the resident is transferred under emergency circumstances."
Thirty days, department discharge notice — RCW 74.42.450(5): the resident "shall not be discharged from the nursing facility until at least thirty days after written notice is given" of a department determination that nursing facility care is no longer required.
Thirty days after a final order, pendency for a department decision — RCW 74.42.450(6): "the resident shall not be discharged without the resident's consent until at least thirty days after a final order is entered upholding the decision to discharge the resident."
Eighteen days a year, social/therapeutic leave — WAC 388-97-0160(3), quoted in full in section 02 above, extendable with the department's prior authorization under WAC 388-97-0160(4).
What any of these periods means for a particular case is for the hearing office or the relevant state process to determine.
Source map
| Document | Publisher and location | Source's own date | Retrieved |
|---|---|---|---|
| RCW 74.42.450 | Washington State Legislature | history line ends 2013 c 23 s 229 | 2026-09-21 |
| WAC 388-97-0120, Individual transfer and discharge rights and procedures | Washington State Legislature | WSR 26-08-015, filed 3/20/26, effective 4/20/26 | 2026-09-21 |
| Washington State Long-Term Care Ombudsman Program — home page | WA LTCOP | none stated beyond the 2026 copyright line | 2026-09-21 |
| WAC 388-97-0160, Discharge or leave of a nursing facility resident | Washington State Legislature | WSR 08-20-062, filed 9/24/08, effective 11/1/08 | 2026-09-21 |
| WAC 388-02-0005, What is the purpose and scope of this chapter? | Washington State Legislature | no per-section date beyond the chapter's own filing history | 2026-09-21 |
| WAC 388-02-0025, Where is the office of administrative hearings located? | Washington State Legislature | no per-section date beyond the chapter's own filing history | 2026-09-21 |
| WAC 388-02-0085, Do you have a right to a hearing? | Washington State Legislature | no per-section date beyond the chapter's own filing history | 2026-09-21 |
| WAC 388-02-0100, How do you request a hearing? | Washington State Legislature | no per-section date beyond the chapter's own filing history | 2026-09-21 |
Captured: all eight, in tools/packets/washington-packet.txt. Pending: the department's own ombuds page (the programme's own site carries the contacts instead); the Office of Civil Legal Aid's discharge programme beyond what the ombudsman programme's own page states about it; a first-party statement, if one exists, of a hospitalization-specific bed-hold day count; and WAC 388-97-0080, cross-referenced by WAC 388-97-0120(3)(b) for the reasonable-accommodation requirements but not itself fetched.
Change log
2026-09-21 — Deepened to a full page: section 01 (the grounds, as Washington 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) are now written. Newly captured, all from the Legislature's own WAC pages by the existing recipe (tools/recipes/washington.json, extended with sources 4-8; recipe digest 92618e36b910, was 25d4b020e4e6): WAC 388-97-0160 (Discharge or leave of a nursing facility resident), which is Washington's social/therapeutic bed-hold provision; and, from chapter 388-02 WAC, the department's general DSHS hearing-procedure rules — WAC 388-02-0005 (scope), WAC 388-02-0025 (the Office of Administrative Hearings' address), WAC 388-02-0085 (the hearing-right and deadline rule), and WAC 388-02-0100 (how to request a hearing). Transport: plain curl, no browser user-agent needed, the same #contentWrapper scope already recorded for this state's first two sources. Findings, continuing the numbering from 2026-08-30: (8) Neither RCW 74.42.450 nor WAC 388-97-0120 cites chapter 388-02 WAC by number anywhere in the captured text. This page treats chapter 388-02 as Washington's general hearing route on the strength of its own stated scope — "Regulates all hearings involving DSHS" — not because either nursing-facility rule names it, and chapter 388-02 itself states that a more specific DSHS program rule would control if one exists; no such specific rule for a facility-initiated discharge was located. (9) Chapter 388-02's only stated hearing-request deadline (ninety calendar days, extendable to a year for good cause) is scoped by its own text to "public assistance cases" under RCW 74.08.080, a different program; this page quotes it only to show that scoping, not as a nursing-facility figure, and states plainly that no deadline for a facility-initiated discharge appeal is stated in the sources reviewed. (10) No separate first-party statement of a hospitalization-specific bed-hold day count was located; WAC 388-97-0120(4)(a) leaves that number to each nursing home's own disclosed policy, and only the eighteen-day annual figure at WAC 388-97-0160(3) is state-set, for social or therapeutic leave specifically. (11) The ombudsman program's recaptured home page (source 3) reads differently in its non-quoted structure than the 2026-09-04 capture — a carousel/navigation restructuring on the site — but every phrase this page quotes from it (the email address, phone, fax, TTY number, street address, and the Office of Civil Legal Aid line) is present and unchanged in both captures, confirmed before promoting the recapture. The recaptured page also now links an "HCBS Notice of Transfer/Discharge Form" and "HCBS Discharge Contact Info," for the home-and-community-based-services program rather than nursing facilities; that addition is outside this page's Medicare/Medicaid-certified-nursing-facility scope and was not investigated further this pass. Capture pending, continuing the 2026-08-30 list, now narrowed: the department's own long-term care ombuds page, which still 404s (the programme's own site continues to carry the contacts); the Office of Civil Legal Aid's discharge programme beyond what the ombudsman page itself states; and WAC 388-97-0080, cross-referenced by WAC 388-97-0120(3)(b) but not itself fetched. WAC 388-97-0160, pending as of 2026-08-30, is captured as of this entry. Internet Archive: not yet submitted for the five newly captured sources. Reviewer: Carrie Schluter, reviewed 2026-09-21. Corrections: hello@fieldassembly.net.
2026-08-30 — Baseline page built from the first Washington packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Washington 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) Washington states two notice periods for the same event, split by facility type: thirty days where a nursing facility initiates the move, fifteen where a nursing home does. Both are quoted as published, and this page does not decide which applies to any building. (2) The statute's grounds and the rule's grounds are different lists — four and six — and the rule reaches its six by requiring compliance with the federal regulations alongside the statute. Both stand as published, and the federal enumeration stays on the federal page. (3) The appeal Washington states in statute is an appeal of a department determination that the resident no longer needs nursing facility care, not of a facility's decision to discharge. That notice carries the hearing-request form, and the resident may not be discharged until at least thirty days after a final order upholding the decision. No captured source states a forum or a deadline for appealing a facility-initiated move, and the hearing row states that gap rather than filling it. (4) The rule requires the facility's notice to be copied to the department, and names two different destinations depending on the reason for the move; that routing is captured and will be quoted in section 02. (5) Washington states its bed-hold rule as a duty to have a policy rather than as a period: the nursing home must develop one consistent with any the department develops, give it in writing before a transfer or therapeutic leave, and state the number of days, if any, it will hold the bed. It also states that a Medicaid-eligible resident whose leave exceeds the maximum will be readmitted to the first available semi-private bed. No number appears in the captured sources. (6) The reasonable-accommodation duty at RCW 74.42.450(7) requires the facility to attempt to avoid the move before making it, and ties "reasonable accommodations" to the federal Americans with Disabilities Act. No other state built so far states that duty as a precondition. (7) The department's own long-term care ombuds page returns 404; the programme's own site carries the contacts, and the packet records the 404 so a later session does not read it as a removed programme. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.