West Virginia
- Grounds stated in the sources
- 64 CSR 13, section 4.13.b: "The nursing home shall permit each resident to remain in the nursing home, unless:" — "The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the nursing home;"; "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 nursing home;"; "The health or safety of persons in the nursing home is endangered;"; "The resident has failed, after reasonable and appropriate notice, to pay for a stay at the nursing home; or"; "The nursing home ceases to operate." A separate subdivision bars one direction of movement outright: "A nursing home shall not discharge a resident requiring the nursing home's services to a community setting against his or her will." A resident may also refuse certain moves within the building, between a Medicare-certified part and a part that is not. The state's Medicaid provider manual restates the same five ideas as six numbered conditions — splitting "health or safety" into two separate bullets and adding detail to the nonpayment ground — worded differently in places; both stand as published in section 01.
- Notice stated in the sources
- Section 4.13.e: "The notice of transfer or discharge shall be made by the nursing home at least thirty (30) days before the resident is discharged or transferred, except the notice shall be made as soon as practicable before a transfer or discharge when:" — the discharge is to a community setting under subdivision 4.13.g, the safety or the health of persons in the nursing home would be endangered, "The resident's health improves sufficiently to allow a more immediate transfer or discharge;", "An immediate transfer or discharge is required by the resident's urgent medical needs; or" "A resident has not resided in the nursing home for thirty (30) days." The notice "shall be in a language the resident understands" and must state the reason, the effective date, "The location or other nursing home to which the resident is being transferred or discharged;", the appeal statement below, "The name, address and telephone number of the State long term care ombudsman;" and, for residents with developmental disabilities or mental illness, the contacts for the responsible protection and advocacy agency. The Medicaid manual's own notice-contents list states the same items and adds a pendency clause the rule itself does not carry — quoted in section 02.
- Hearing office in these sources
- The State Board of Review, which the rule defines as "A board designated by State law through which a resident may appeal a discharge from a nursing home." The notice must carry "A statement that the resident has the right to appeal the action to the State Board of Review, with the appropriate information regarding how to do so;". The rule states no address, no form and no deadline, and leaves "the appropriate information regarding how to do so" to the facility to supply. The state's Medicaid provider manual, not the rule, is the source that states pendency: the notice's appeal statement must say that "during this time of appeal, the resident/member may choose to stay in the facility". No captured source publishes the Board's own procedure, address, form or deadline.
- Ombudsman in these sources
- The Long-Term Care Ombudsman Program. The Bureau of Senior Services states that "West Virginia's State Ombudsman is employed by the Bureau of Senior Services, and the Bureau contracts with West Virginia Legal Aid to conduct the day-to-day operation of the program via an Ombudsman Supervisor and nine Regional Ombudsmen." Its published route is "call 1-800-834-0598 to speak with an ombudsman or to request services." The Bureau itself is at "1900 Kanawha Blvd. East" "Charleston, WV 25305" with "Phone: (304) 558-3317, (877) 987-3646". The rule defines an ombudsman as "Any person or organization designated by the State Long Term Care Ombudsman as part of the West Virginia Long-Term Care Ombudsman Program."
- Sources last checked
- Sep 22, 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 West Virginia's own publishers state about transfer and discharge from a nursing home. Nearly all of the licensure side sits in one place — section 4.13 of 64 CSR 13, the Nursing Home Licensure Rule — which states the grounds, the thirty-day notice and its exceptions, the notice's required contents, the duty to help find an alternative placement, and a prohibition on discharging a resident to the community against their will. A second first-party publisher, the Bureau for Medical Services' Medicaid provider manual (Chapter 514, Effective 10/1/2024), restates the same subject in its own words for Medicaid nursing facilities, states the state's Medicaid bed-hold policy the licensure rule never addresses, and is the only source that states the appeal is a stay: that the resident "may choose to stay in the facility" while it is pending. West Virginia's vocabulary is transfer or discharge, and the appeal goes to a body the rule calls the State Board of Review.
Two things are worth a reader's attention. West Virginia states a duty other states leave out: on an involuntary transfer the nursing home "shall assist the resident or legal representative or both in finding a reasonably appropriate alternative placement prior to the proposed transfer or discharge and by developing a plan designed to minimize any transfer trauma to the resident." And the appeal, though it has a named forum, has no published address or clock in either source — each requires the facility's own notice to supply "the appropriate information regarding how to do so" — and neither the rule nor the manual states it. 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 West Virginia describes them
64 CSR 13, section 4.13.b: "The nursing home shall permit each resident to remain in the nursing home, unless:"
"The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the nursing home;"
"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 nursing home;"
"The health or safety of persons in the nursing home is endangered;"
"The resident has failed, after reasonable and appropriate notice, to pay for a stay at the nursing home; or"
"The nursing home ceases to operate."
The same subsection bars one direction of movement outright, stated separately from the five conditions above: "A nursing home shall not discharge a resident requiring the nursing home's services to a community setting against his or her will."
The Medicaid provider manual, at section 514.8.2, restates the same subject for Medicaid nursing facilities in different words and a different count — six numbered conditions rather than five, because it splits the rule's combined "health or safety" ground into two: "The administrator or designee must permit each resident to remain in the facility, and not be" transferred or discharged from the facility, "unless one of the following conditions is met:"
"The transfer or discharge is necessary for the resident's welfare when the needs of the resident cannot be met in the facility; or"
"The transfer or discharge is appropriate because the health of the resident has improved sufficiently that the individual no longer meets the medical criteria for nursing facility services; or"
"The safety of individuals in the facility is endangered; or"
"The health of individuals in the nursing facility would otherwise be endangered; or"
"The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicaid) a stay at the nursing facility, including but not limited to, the amount of money determined by the financial eligibility evaluation as co-payment for the provision of nursing facility services; or"
"The facility ceases to operate."
Both are quoted as published; this page does not decide which count of grounds — five or six — is the state's real answer, because both are the state's own current publications.
The published process
Requesting the hearing
Neither first-party source names an address, a form, or a filing deadline for the appeal to the State Board of Review. 64 CSR 13 defines the forum in one sentence — "A board designated by State law through which a resident may appeal a discharge from a nursing home." — and requires the facility's own notice to carry "A statement that the resident has the right to appeal the action to the State Board of Review, with the appropriate information regarding how to do so;", leaving that information to the facility rather than stating it in the rule. The Medicaid provider manual states the same appeal right in its own notice-contents list, and adds the one statement neither source states anywhere else — that the move is stayed while an appeal is open: "A statement that the resident has the right to appeal the action to the State Board of Review, during this time of appeal, the resident/member may choose to stay in the facility". No source states how long that stay lasts, how the appeal is filed, or to what address.
The notice's required contents
64 CSR 13, section 4.13.d.1: notice "shall be in a language the resident understands and shall include the following:" "The reason for the proposed transfer or discharge;", "The effective date of the proposed transfer or discharge;", "The location or other nursing home to which the resident is being transferred or discharged;", "A statement that the resident has the right to appeal the action to the State Board of Review, with the appropriate information regarding how to do so;", "The name, address and telephone number of the State long term care ombudsman;", and, in separate paragraphs, the mailing address and telephone number of the protection-and-advocacy agency for residents with developmental disabilities and, separately, for residents who are mentally ill.
The Medicaid provider manual's own list, section 514.8.2, covers the same ground with different phrasing and, on the appeal statement, different substance: "The written notice must include the following:" "The effective date of the transfer or discharge;", "Reason for the discharge;", "The location or person(s) to whom the resident is transferred or discharged;", the pendency-bearing appeal statement quoted above, "The name, address, and telephone number of the State long-term care ombudsman; and", and, for residents with developmental disabilities, "the mailing address and telephonenumber of the agency responsible for the protection and advocacy of developmentally disabledand mentally ill individuals" — one combined item where the rule states two. Before either notice goes out, the manual states the facility "must notify the resident and/or the responsible party verbally and in writing, in an accessible format that is understandable to the parties, of the intent and reason for transfer or discharge." A copy of that notice "must be sent to the State Long-Term Care Ombudsman or their designee" — a requirement the rule does not state.
Bed-hold and return
64 CSR 13 states none: no first-party licensure statement of a bed-hold period was found in the sources reviewed (searched: section 4.13's admission, transfer and discharge provisions in full, and the rule's definitions). The state's Medicaid provider manual does. Section 514.8.3, for rate periods beginning October 1, 2024: "a nursing facility may receive Medicaid per diem reimbursement to reserve a resident's bed (bed hold) during his/her temporary absence from the facility, for a maximum of 18 days (for all types of leave). This is paid at the facility's non-acuity adjusted reimbursement rate." Before that date, the manual states a different, narrower policy conditioned on occupancy: "The facility's occupancy must be 95% or greater as of midnight on the day immediately before the time that the resident leaves and there must be a current waiting list for admission to the nursing facility." Both are quoted as the manual's own record of what changed, not calculated into a single rule.
On return, the current text: "The resident whose bed is reserved is to be accepted by the facility immediately upon return from leave. Placement is to be in the same bed and living space occupied by the resident prior to the leave of absence unless the resident's physical condition upon returning to the facility prohibits access to the bed previously occupied." Where the reserved days run out, "a facility may charge a resident to reserve a bed only when there are no vacancies and there is a current waiting list." "the amount paid is not considered as a resource or income for Medicaid purposes." A former resident who left without a bed hold in place still has a return right: "a former resident has the right to be re-admitted to the first available bed in a semi-private room in the nursing facility from which he or she came if the resident requires the services provided by the nursing facility and has not been out of the facility for more than 30 days."
The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from West 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.
Thirty days, ordinarily — 64 CSR 13, section 4.13.e: "The notice of transfer or discharge shall be made by the nursing home at least thirty (30) days before the resident is discharged or transferred".
As soon as practicable, for five stated exceptions — the same subsection: notice "shall be made as soon as practicable before a transfer or discharge when" the discharge is to a community setting, safety or health would be endangered, the resident's health improves enough to allow a more immediate move, an immediate move is required by urgent medical needs, or "A resident has not resided in the nursing home for thirty (30) days."
Thirty days, in the Medicaid manual's own notice period — section 514.8.2: notice "must be provided at least 30 days prior to the anticipated move to ensure a safe and orderly discharge to a setting appropriate to the individual's needs." Three exceptions are stated, narrower than the rule's five rather than the rule's five: "Waiver of this 30-day requirement may be appropriate if the safety of individuals in the facility would be endangered, the immediate transfer is required by the resident's urgent medical needs, or a resident has not resided in the nursing facility for 30 days."
Eighteen days of bed-holding a year, for all leave combined, from October 1, 2024 — 514.8.3: "a nursing facility may receive Medicaid per diem reimbursement to reserve a resident's bed (bed hold) during his/her temporary absence from the facility, for a maximum of 18 days (for all types of leave)."
Thirty days for a former resident's return right — 514.8.3: readmission to the first available bed applies to a resident who "has not been out of the facility for more than 30 days."
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 |
|---|---|---|---|
| 64 CSR 13, Nursing Home Licensure Rule — section 4.13, definitions, and opening | West Virginia Secretary of State, Code of State Rules (Word document) | none stated in the captured span | 2026-09-22 |
| Long-Term Care Ombudsman Program | West Virginia Bureau of Senior Services | Updated 3/25/24 | 2026-09-22 |
| BMS Provider Manual, Chapter 514 Nursing Facility Services — transfer/discharge policy and bed reservation | West Virginia Bureau for Medical Services (PDF) | Effective: 10/1/2024 | 2026-09-22 |
Captured: all three, in tools/packets/west-virginia-packet.txt. Pending: the State Board of Review's own procedure, address and deadline; W. Va. Code § 16-5C-1 et seq.; the ombudsman brochure.
Change log
2026-09-22 — Deepened to a full page. One new first-party source was captured beyond the two used at baseline: the Bureau for Medical Services' Medicaid provider manual, Chapter 514 Nursing Facility Services (Effective 10/1/2024), which restates the transfer/discharge policy for Medicaid facilities and states West Virginia's Medicaid bed-hold rule — absent from every licensure source captured at baseline. Captured by curl through this state's recipe (tools/recipes/west-virginia.json, source 5), the same transport already in use for the licensure rule's Word-document download.
Findings: (1) The manual states the appeal is a stay. Its own notice-contents list requires the appeal statement to say "during this time of appeal, the resident/member may choose to stay in the facility" (quoted without its closing punctuation, a semicolon in the source list) — the pendency provision CHARTER.md's "requesting the hearing" row calls for, and one that 64 CSR 13 itself never states. This is exactly the shape CLAUDE.md's four-publisher-per-state observation anticipates: the rule and the Medicaid manual are two different first-party statements of the same procedure, and only one of them carries this fact. (2) The two sources do not agree on how many grounds the state has. The rule states five conditions under which a resident may be moved; the manual states six, because it splits the rule's combined "health or safety of persons... is endangered" into two separate conditions, one for safety and one for health, and adds a Medicaid co-payment clause to the nonpayment ground the rule does not carry. Both stand as published; this page does not decide which count is authoritative. (3) The two notice periods also diverge in their exceptions: the rule states five circumstances that shorten the thirty-day notice to "as soon as practicable," the manual states three, and the manual's three are a subset of the rule's five (it does not separately state the community-setting or health-improvement exceptions). (4) West Virginia's Medicaid bed-hold policy itself changed on October 1, 2024: an occupancy-conditioned policy (95% occupancy and a waiting list required) gave way to a flat 18-day annual allowance for all leave combined, and the manual states both as its own record of the change — quoted rather than only the current figure, so a reader comparing this page to an older document is not misled into thinking the state is silent on the earlier period. (5) The manual requires a copy of the transfer/discharge notice to go to the State Long-Term Care Ombudsman directly — a requirement the licensure rule does not state. (6) No street address, form, or deadline for the State Board of Review appeal was found in either source; that absence, recorded at baseline, stands. Capture pending: per the source map. Internet Archive: not yet submitted for the new source. Reviewer: Carrie Schluter, reviewed 2026-09-22.
2026-09-08 — Quotation correction: two spaces this page supplied. While building this state's capture recipe (tools/recipes/west-virginia.json), the fresh capture stopped matching two published quotations in the ombudsman row: "Ombudsman Supervisor and nine Regional Ombudsmen ." carried a space before its period, and "Phone: (304) 558-3317 , (877) 987-3646" carried a space before its comma. The source's own aspx page sets the word "Ombudsmen" and the first phone number as links; the 2026-08-30 capture's tag strip inserted a space at each link boundary, matching the same class of artifact already found and corrected on Nebraska, Ohio and North Dakota (see CLAUDE.md, "Link-boundary spaces"). Both spaces have been dropped; no wording changed. Verified against a fresh recipe-driven capture (tools/packets/review/west-virginia-2026-09-08.txt), which renders both spans without the stray space, and both now trace with zero fidelity failures. Reviewer: Carrie Schluter, reviewed 2026-09-08. Corrections: hello@fieldassembly.net.
2026-08-30 — Baseline page built from the first West Virginia packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as West Virginia 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) The rule names a forum — the State Board of Review — and publishes nothing about how to reach it. It defines the Board in one sentence, requires the facility's own notice to carry "the appropriate information regarding how to do so", and states no address, form, deadline or stay. The hearing row records that split: a named office with an unpublished procedure. (2) West Virginia requires the nursing home to help find a reasonably appropriate alternative placement before an involuntary transfer, and to develop a plan to minimise transfer trauma. Only Wisconsin, among the states built so far, states a comparable duty. (3) The rule bars discharging a resident who needs nursing home services to a community setting against their will, and requires the facility to document that a resident voluntarily discharged to the community understood all options. Framed this way, the community-discharge protection is a ground the facility may not use rather than a procedure the resident must invoke. (4) The Secretary of State serves this rule as a Word document. The same endpoint with Format=HTML, Format=PDF and Format=TEXT returns an identical 60-page scanned PDF with no text layer, so the Word file is the only machine-readable copy the state publishes; the packet records the conversion method, because a naive byte-level extraction of that file silently drops short lines and breaks apostrophes. (5) The state ombudsman is employed by the Bureau of Senior Services, which contracts day-to-day operation to West Virginia Legal Aid; the Bureau's page states that arrangement itself, and it is quoted rather than summarised. (6) No first-party statement of a West Virginia 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.