Nursing Homes
Nursing Home Discharge Notices: When a Facility Says Your Stay Is Ending and How to Appeal
A nursing home cannot end a stay without a written notice that states the reason and your appeal rights. See what the notice must say and how an appeal can pause a discharge.
Key takeaways
- A discharge or transfer must come with a written notice. A verbal word alone is not enough.
- The notice must state the reason, the planned end date, where the person would go, and how to appeal.
- The skilled nursing benefit runs up to 100 days per benefit period, after a qualifying inpatient hospital stay of at least 3 days (Ledger B2).
- Skilled nursing coinsurance is $217.00 a day for days 21 to 100. Days 1 to 20 are $0 (Ledger A8).
- For cost context only: a semi-private room has a national median of $9,581 a month and a private room $10,798 a month (Ledger F5 and F6, CareScout 2025 survey). These are survey medians, not rates for one home.
- Act fast when a notice comes. The notice and the appeal form state the dates for your case. No deadline is stated here, since deadlines are set in your own papers.
A staff member hands you a form and says the stay is ending. Panic is a normal first response. But a home cannot end a stay on a verbal word alone. It must give a written notice. That notice must state the reason, the end date, and how to appeal. This guide shows what to look for in the notice and what an appeal does. See our Nursing Homes section for more guides on stays and costs.
Two unlike notices families confuse
The first is a discharge notice from the home. It says the home plans to end the stay or move the person to a unlike place. It is about the home and the stay itself.
The second is a Medicare notice about coverage. It says Medicare will stop paying for skilled care on a set date, often since the care no longer meets the skilled test. It is about payment, not about the home as a place to live.
A family can get both at near the same time. They are not the same form, and each has its own appeal path. Read the head of each form to tell which one you hold. If you are not sure, ask staff to state, in writing, which notice each form is.
A coverage end does not by itself force a person out that day. A person who still needs care may stay and pay in a unlike way, or appeal the coverage call. A discharge notice is the form that seeks to end the stay. Keep that line clear in every call you make.
What a discharge notice must state
A valid notice gives the facts a family needs to respond. Look for each of these parts:
If a part is missing, say so in writing to the home. Keep a copy of the notice and of your note. Dates matter in a dispute, so keep proof of the day each paper came to you.
Homes may end a stay only for reasons the rules allow. Common allowed grounds in the rules are that the person's health has grown to the point the stay is no longer needed, the person's needs cannot be met in that home, the health or safety of others is at risk, or the home closes. Non-payment can be a ground in set cases, after notice. If the reason on your notice is vague, ask for the exact ground in writing.
- The reason the home gives for the discharge or transfer.
- The date the home plans for the move.
- The place the person would go, if the home has named one.
- A statement of the right to appeal, and how to start an appeal.
- Contact facts for the state long-term care ombudsman program and the state survey agency.
Who pays for what
- Original Medicare pays for skilled nursing care in the benefit span, up to 100 days per benefit period after a qualifying stay (Ledger B2). You pay $0 for days 1 to 20 and $217.00 a day for days 21 to 100 (Ledger A8).
- Medicaid can pay for a long stay for residents who qualify. A Medicaid resident has discharge rights too. A coverage change is not a free pass to end a stay.
- Your home is paid by the payer for each day of a covered stay. It cannot bill you for days a payer covers.
- You pay private rates if you stay past covered care with no other payer, and for items no payer covers. A semi-private room median is $9,581 a month and a private room median is $10,798 a month (Ledger F5 and F6), as scale marks only.
- Private pay also covers a new place if a lawful discharge goes ahead and no payer covers the next setting.
Sample situation
Henry is 84. He came to the home after a hospital stay for skilled therapy. In his third week, staff hand his daughter a notice that says Medicare coverage will end and the home plans a discharge. His daughter reads both forms as one. She then sorts them. One form is a coverage notice. The other is a discharge notice with a reason she finds vague. She calls the number on the coverage form and starts that appeal at once, since that appeal can pause the coverage end while it is judged. She writes to the home and asks for the exact ground for discharge, in writing. She calls the ombudsman program listed on the notice. Henry stays while both tracks run. His coinsurance for those skilled days is $217.00 a day for days 21 to 100 (Ledger A8). The family uses the time to plan a safe next step, in place of a rushed move.
How to appeal, step by step in broad terms
Our nursing home cost guide shows what a stay costs as a whole. Our private room vs semi-private room guide, posted on November 5, shows how room choice changes cost. Slot 10 in this group covers the Medicaid personal needs allowance, the small amount a resident keeps each month.
An appeal does not always win. Its worth is time and a fair review. Use that time well. Tour other settings if a move may come. Ask about bed hold and return rules if a hospital trip is the cause. A calm plan beats a forced move in every case.
- Read the notice in full the day it comes. Note the end date it states.
- Call the appeal contact on the form at once. Tell them you appeal. Note the name, date, and time of the call.
- Send any written appeal the form calls for, and keep proof you sent it on that date.
- Ask the home and your doctor for records that support the need for care or for the stay. Send them to the appeal reviewer.
- Call the ombudsman program. Its staff can help you state your case and can attend meetings with the home.
- Do not sign a form that says you agree to leave if you do not agree. If you feel pressed, say you need time and advice, and note who pressed you and when.