Nursing Home Discharge Notification Tool Kit
June 16, 2026 | Resources
Resources for Residents:
Your Rights:
- You have the right to remain in the nursing facility unless a transfer or discharge:
- (a) is necessary to meet the resident’s welfare;
- (b) is appropriate because the resident’s health has improved and s/he no longer requires nursing home care;
- (c) is needed to protect the health and safety of other residents or staff;
- (d) is required because the resident has failed, after reasonable notice, to pay the facility charge for an item or service provided at the resident’s request
- Receive thirty-day notice of transfer or discharge which includes the reason, effective date, location to which the resident is transferred or discharged, the right to appeal, and the name, address, and telephone number of the State Long-Term Care Ombudsman
- Safe transfer or discharge through sufficient preparation by the nursing home
- 10-238 (Request for Administration Hearing)
For help call the Washington State LTC Ombudsman Program at 800-562-6028 or email at ltcop@mschelps.org
Updates for Providers:
07/01/2026 to include Request for an Administrative Hearing
- Discharge Postcard-template 6.12.18
- 10-237 – NH Discharge Form (Updated 1.14.26)
- LTCOP-Fact Sheet NHs re discharge notices 6.17.26 – to include notification to the LTCO Program for “emergency transfers”.
Frequently Asked Questions:
A nursing facility that transfers or discharges a resident must send a copy of the notice to the State LTC Ombuds. For more information, read the Q & A below and refer to 42 C.F.R. § 483.15(c)(3)(i).
- Who must send a copy of transfer and discharge notices to the State LTC Ombuds?
- All nursing facilities that transfer or discharge a resident must send a copy of the notice to the State LTC Ombuds.
- What must the facility send to the State LTC Ombuds?
- The facility must send a copy of the written notice of transfer or discharge that the facility gives to the resident and the resident’s representative. To provide notice to the resident and resident’s representative, facilities may use the optional form, “DSHS 10-237 – Nursing Home Transfer or Discharge Notice.” DSHS provides this form in English and in other languages (search for “10-237” in the “Form Number” box). Any form used by the facility must comply with all relevant laws.
- When must the facility send a copy of the notice to the State LTC Ombuds?
- According to the Centers for Medicare & Medicaid Services (CMS):*
- For discharges and transfers – A copy of each notice must be sent to the State LTC Ombuds at the same time the notice is provided to the resident and resident
- For emergency transfers to acute care settings – Copies may be sent to the State LTC Ombuds when practicable, such as in a list of residents on a monthly basis, as long as the list meets all requirements for content of such notices at 42 F.R. § 483.15(c)(5).
- How must the facility send a copy of the notice to the State LTC Ombuds?
- The facility must send a copy of the notice to the State LTC Ombuds by email to LTCOP@mschelps.org, or by fax to (253) 815-8173. Copies sent by postal mail will not be accepted. Information cards with contact information for the State LTC Ombuds are available here.
- May the facility send a copy of the notice to the Regional LTC Ombudsman Program?
- No. The copy of the notice must be sent directly to the State LTC Ombuds.
- May the facility send a monthly list of all residents who receive transfer notices?
- According to CMS,* the facility may send a monthly list to the State LTC Ombuds but only for emergency transfers to acute care settings. (A template list is available with this FAQ.) However, for discharges and all other transfers, the facility cannot send a list; it must send a complete copy of each notice to the State LTC Ombuds.
- What will the State LTC Ombuds do with the copy of the notice?
- The State LTC Ombuds will forward it to the appropriate Regional LTC Ombuds. Upon review of the notice, an Ombuds might contact the resident or their representative to offer help or ask for clarifying information. However, we will not automatically advocate for the resident, due to limited resources and laws requiring consent to Ombuds services. To request assistance from an Ombuds, the resident (or a person concerned about the resident) should contact the closest Regional LTC Ombudsman Program by calling (800) 562-6028 or visiting www.waombudsman.org and selecting “Find an Ombuds.”
- Is the facility required to get consent from the resident or resident representative before sending a copy of the notice to the State LTC Ombuds?
- No. The State LTC Ombudsman Program is a “health oversight agency” for the purposes of federal and state privacy laws. Facilities are not required to seek or obtain consent prior to sending a copy of the transfer or discharge notice to the State LTC Ombuds. Once received by the State LTC Ombuds, the copy will become an Ombudsman Program record and will be subject to strict confidentiality requirements under federal and state laws.
- Is sending a copy of the notice to the State LTC Ombuds the same as referring to a resident to the LTC Ombudsman Program?
- No. Sending a copy of the notice to the State LTC Ombuds only fulfills the requirement in 42 C.F.R. § 483.15(c)(3)(i). Referral to the LTC Ombudsman Program means asking for assistance for that resident. The resident can make this request themselves, or someone else can do so on the resident’s behalf. To request assistance from an Ombuds, the resident (or a person concerned about the resident) should contact the closest Regional LTC Ombudsman Program by calling (800) 562-6028 or visiting www.waombudsman.org and selecting “Find an Ombuds.”
- If the information in the notice to the resident changes, is the facility required to send an updated copy to the State LTC Ombuds?
- Yes. An updated notice of transfer or discharge must be sent to each resident and resident representative. A copy of the updated notice must be sent to the State LTC Ombuds at the same time.
- If the resident has left the facility (for example, the resident is in the hospital or on therapeutic leave) at the time of transfer or discharge, is the facility still required to send a copy of the notice to the State LTC Ombuds?
- Yes. The facility must provide the State LTC Ombuds a copy of the notice of transfer or discharge that is provided to the resident and resident representative.
- Is the facility required to send a copy of the notice to the State LTC Ombuds if the resident pays privately?
- Yes. A copy must be sent to the State LTC Ombuds regardless of the resident’s payment source.
- In addition to written notice, what other requirements apply to transfer or discharge?
- Facilities must fulfill all legal obligations related to transfer and discharge, including but not limited to first attempting through reasonable accommodations to avoid the transfer or discharge and providing sufficient preparation and orientation to residents to ensure a safe and orderly transfer or discharge. See the state resident rights act, RCW 70.129.110. For additional information, please refer to all relevant federal and state laws and CMS Long-Term Care Surveyor Guidance. You can also contact Residential Care Services at DSHS, your member association office, or your legal counsel.
* Source: Ctrs. for Medicare & Medicaid Servs., State Operations Manual, Appendix PP – Guidance to Surveyors for Long Term Care Facilities, F628 at 200, (eff. Apr. 28, 2025).
NOTE: This document is intended to provide general information. It is not a substitute for legal advice. Receipt of copies of transfer or discharge notices by the State LTC Ombuds does not constitute waiver of any rights, nor does it constitute admission by the State LTC Ombuds that such notices meet legal requirements.
Thank you for taking the time to read this information. You should consult your legal counsel if you have questions of a legal nature or have questions about the content of this fact sheet.
WA LTCOP V.1.0 6/17/2026