This bulletin contains an updated sample notice and current Ombudsman directory for use with the 30 day discharge/transfer notice given a resident prior to involuntary discharge or transfer. (This information supercedes Information Bulletin 92-4.)

The sample notice has been revised to identify the Minnesota Disability Law Center as the agency responsible for protection and advocacy of nursing home residents with developmental disabilities or mental illness. Also added to the notice is a statement that the resident has 30 days from receipt of the discharge notice to appeal.

42 CFR 483.12 (a)(6) provides that:

The written notice specified in paragraph (a)(4) of this section must include the following:

  1. The reason for transfer or discharge;
  2. The effective date of transfer or discharge;
  3. The location to which the resident is transferred or discharged;
  4. A statement that the resident has the right to appeal the action to the State;
  5. The name, address and telephone number of the State long term care ombudsman;
  6. For nursing facility residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled individuals established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act; and
  7. For nursing facility residents who are mentally ill, the mailing address and telephone number of the agency responsible for the protection and advocacy of mentally ill individuals established under the Protection and Advocacy for Mentally Ill Individuals Act.

Correct Notice Procedure

Corrected information given subsequent to the discharge notice is not sufficient to comply with the provisions of the regulations which require that this information be provided at the time of the issuance of the notice.

On several occasions facilities have had to reissue the notice of discharge because the notice was not in compliance with the provisions of 42 CFR 483.12 (a)(6). They have then had to provide a new 30 day notice period.

Failure to reissue the notices will result in the issuance of a federal deficiency.

144A.135 Transfer and Discharge Appeals

  1. The commissioner shall establish a mechanism for hearing appeals on transfers and discharges of residents by nursing homes or boarding care homes licensed by the commissioner. The commissioner may adopt permanent rules to implement this section.
  2. Until federal regulations are adopted under sections 1819(f)(3) and 1919(f)(3) of the Social Security Act that govern appeals of the discharges or transfers of residents from nursing homes and boarding care homes certified for participation in Medicare or medical assistance, the commissioner shall provide hearings under sections 14.57 to 14.62 and the rules adopted by the office of administrative hearings governing contested cases. To appeal the discharge or transfer, or notification of an intended discharge or transfer, a resident or the resident’s representative must request a hearing in writing no later than 30 days after receiving written notice, which conforms to state and federal law, of the intended discharge or transfer.
  3. Hearings under this section shall be held no later than 14 days after receipt of the request for hearing, unless impractical to do so or unless the parties agree otherwise. Hearings shall be held in the facility in which the resident resides, unless impractical to do so or unless the parties agree otherwise.
  4. A resident who timely appeals a notice of discharge or transfer, and who resides in a certified nursing home or boarding care home, may not be discharged or transferred by the nursing home or boarding care home until resolution of the appeal. The commissioner can order the facility to readmit the resident if the discharge or transfer was in violation of state or federal law. If the resident is required to be hospitalized for medical necessity before resolution of the appeal, the facility shall readmit the resident unless the resident’s attending physician documents, in writing, why the resident’s specific health care needs cannot be met in the facility.
  5. The commissioner and office of administrative hearings shall conduct the hearings in compliance with the federal regulations described in paragraph (b), when adopted.
  6. Nothing in this section limits the right of a resident or the resident’s representative to request or receive assistance from the office of ombudsman for older Minnesotans of the office of health facility complaints with respect to an intended discharge or transfer.

The agency responsible for the advocacy of the developmentally disabled and mentally ill is:

Minnesota Disability Law Center 
430 First Avenue North
Suite 300
Minneapolis, MN 55401
(612) 332-1441
1 (800) 292-4150
TDD: (612) 332-4668


Minnesota Board on Aging
P.O. Box 64971
St. Paul, Minnesota 55164-0971
Telephone: (651) 431-2555
FAX: (651) 431-7452
1-800-657-3591 (toll-free for calls in Greater Minnesota)



Sample Notice
Notice Of Transfer Or Discharge


This is to notify you that [name of facility] will [discharge or transfer] you to on [date]. The reason for this transfer or discharge is:

(insert reason for discharge or transfer)

The federal law that allows us to transfer or discharge you states that: [quote one or more of the reasons in sections 1819(c)(2)(A)(i) through (vi) and 1919(c)(2)(A)(i) through (vi)].

You have a legal right to appeal this transfer or discharge to the State of Minnesota. If you appeal, a hearing will be held at which you or your representative will have the opportunity to explain your side of the dispute. You may be represented by anyone you choose. You may settle the disagreement at any time.

If the facility is discharging you because the county or state eliminated or reduced your governmental benefits, you may appeal and have a hearing by writing to:

Minnesota Department of Human Services
Appeals Division
444 Lafayette Road
St. Paul, MN 55155-3813

If the facility is discharging you for any other reason, write to :

Department of Health
Attn: Appeals Coordinator
Office of Health Facility Complaints
P.O. Box 64970
St. Paul, MN 55164-0970
Telephone: (651) 201-4201 or (800) 369-7994
Fax: (651) 281-9796

The appeal request must be made in writing within 30 days of receiving the notice of discharge or transfer . It should include the following information:

  1. Resident’s name;
  2. Name and address of the nursing home;
  3. A brief description of why you think the discharge or transfer is improper;
  4. A request for a hearing; and
  5. If possible, a copy of this notice of transfer or discharge.

For more information, you may call the Department of Health at (651) 201-4201, or the Department of Human Services at (651) 431-2555.

You may also contact the Office of the Ombudsman for Long-Term Care for information or assistance. Call or write:

[Name, address, and telephone number of the ombudsman in your region.]

If you have a developmental disability or a mental illness, you may contact:

Minnesota Disability Law Center
430 First Avenue North, Suite 300
Minneapolis, Minnesota 55401
(612) 332-1441
1 (800) 292-4150
TDD: (612) 332-4668

CREDIT: Some or all of this was extracted from a publication produced by the Minnesota Department of Health.