Can a nursing home discharge you while your Medicaid application is pending?

Not for nonpayment. CMS guidance to inspectors says the resident cannot be discharged for nonpayment while a decision on the resident's Medicaid eligibility is pending.

How much notice does a nursing home have to give before a discharge?

Generally at least 30 days. The notice may come as soon as practicable instead when other people's health or safety would be endangered, the resident's health has improved enough for an earlier move, urgent medical needs require an immediate move, or the resident has lived in the home for less than 30 days.

How do you appeal a nursing home discharge?

Follow the appeal instructions in the notice, which must name the office that receives appeal requests and give its contact details. Each state must offer a hearing. Federal rules let states set the deadline but not more than 90 days from the date the notice is mailed, and some states, such as Illinois (10 days) and Vermont (10 business days), set much shorter deadlines. The long-term care ombudsman can help with the appeal.

Can a nursing home refuse to take a resident back after a hospital stay?

If the home decides that a resident who went to the hospital cannot return, it must follow the same discharge rules, including written notice and appeal rights. CMS guidance says the decision must rest on the resident's condition when they seek to return, and that a resident who appeals from the hospital must be allowed to return while the appeal is pending, unless there is evidence the home cannot meet the resident's needs or the return would endanger health or safety.

Can a nursing home discharge a resident for behavior?

Only within the six reasons, such as when the safety or health of people in the home is endangered because of the resident's clinical or behavioral status. A physician must document that reason in the medical record, and the notice and appeal rights still apply.

Rights and problems

Can a nursing home kick you out? Discharge rules and how to appeal

Q: Can a nursing home discharge a resident for not paying?

Nonpayment is one of the six reasons federal rules allow, after reasonable and appropriate notice. It covers not submitting the paperwork for Medicare, Medicaid or other payment, or refusing to pay after a claim is denied. Once a resident becomes eligible for Medicaid after admission, the home may charge only what Medicaid allows, and CMS guidance says switching from the private rate to the Medicaid rate is not nonpayment.

Esta guía también está en español.

By Nursing Home Checker · Updated Oct 9, 2026 · How guides are checked

Key takeaways

A Medicare- or Medicaid-certified nursing home must let a resident stay unless one of six reasons in federal rules applies.
The home must give written notice, usually at least 30 days ahead, with a copy to the long-term care ombudsman.
The notice must explain how to appeal. While an appeal is pending, the home may not move the resident unless staying would endanger the health or safety of the resident or others.
CMS guidance says a resident cannot be discharged for nonpayment while a decision on their Medicaid application is pending.

Not without a reason that federal rules allow, and not without written notice and the chance to appeal. A nursing home certified for Medicare or Medicaid must let each resident stay unless one of six reasons applies. The notice usually has to come at least 30 days ahead, and while an appeal is pending the home may not move the resident unless staying would endanger the health or safety of the resident or others.

Got a discharge notice? Do these first

Find the effective date and the reason on the notice. The reason must be one of the six listed below.
Call the long-term care ombudsman. The home must send the ombudsman a copy of the notice, and the notice must give the ombudsman's phone number, mailing address and email.
Ask for a hearing using the instructions on the notice. The notice must give the name, mailing and email address and phone number of the office that receives appeal requests, and say how to get an appeal form and help completing and submitting it. Each state sets its own deadline, no longer than 90 days from the date the notice was mailed, and some states are much shorter. The federal rule on staying during an appeal refers to 42 CFR § 431.230, which applies when the hearing is requested before the date the discharge is to take effect.
Keep copies of the notice, the appeal request and the date you sent it.

What are the six reasons a nursing home can discharge a resident?

Federal rules (42 CFR § 483.15(c)(1)) allow a transfer or discharge only when:

it is necessary for the resident's welfare and the home cannot meet the resident's needs;
the resident's health has improved enough that they no longer need the home's services;
the safety of people in the home is endangered because of the resident's clinical or behavioral status;
the health of people in the home would otherwise be endangered;
the resident has not paid, after reasonable and appropriate notice; or
the home stops operating.

The reason must be documented in the resident's medical record. For the first two reasons, the resident's own physician must document it; for the two endangerment reasons, a physician must. When the reason is that the home cannot meet the resident's needs, the record must say which needs, what the home tried, and what the new place offers that will meet them.

What counts as nonpayment?

Under the rule, nonpayment includes not submitting the paperwork for Medicare, Medicaid or another payer, or refusing to pay after a claim is denied. Once a resident becomes eligible for Medicaid after admission, the home may charge only what Medicaid allows.

CMS guidance to state inspectors adds two points:

A resident cannot be discharged for nonpayment while a decision on their Medicaid eligibility is pending.
Switching from the private-pay rate to the Medicaid rate is not nonpayment.

Differs by stateWhen private money runs out: state rules

California: In a home that takes Medi-Cal, a resident may not be discharged, or moved within the home, only because they switch from paying privately or through Medicare to Medi-Cal; the one exception is a possible move from a private room to a semiprivate room. Under SB 1354 (2024), homes certified for Medi-Cal must give Medi-Cal residents care and services in the same manner and at the same level and quality as the general public, including in admissions, room placement and meals.
Florida: A home certified for Medicaid may not transfer or discharge a resident only because the source of payment for their care changes. A discharge for not paying a bill requires 30 days' notice.
Georgia: Georgia's residents' rights rules say that when a resident switches from private pay to Medicaid because their own money has run out, this does not count as nonpayment of fees, as long as the facility takes part in the Medicaid program. Nonpayment is otherwise one of the allowed reasons for an involuntary discharge.
Illinois: A home that takes Medicaid may not refuse to keep a resident because the person receives or has applied for Medicaid. If only part of a home is Medicaid-certified, a resident in the other part who can no longer pay without Medicaid may be discharged only if the home explained this in writing at admission and the other conditions in the law are met.
Iowa: Iowa law says a resident of a licensed health care facility, including a nursing facility, shall not be discharged solely because their care is paid by Medicaid or because their payment source is changing from private funds to Medicaid. State rules repeat this for nursing facilities, and a violation is at least a class II violation and may be a class I violation.
Kansas: Kansas Medicaid rules say a nursing facility may not require a private-paying resident to stay on private pay for any period after the resident becomes eligible for Medicaid (K.A.R. 30-10-6(c)), and, as a condition of taking part in Medicaid, may not set up private-pay wings or move Medicaid residents to separate areas (K.A.R. 30-10-1f).
Massachusetts: Massachusetts Attorney General rules make it an unfair or deceptive practice for a nursing home that has a Medicaid provider agreement to require an applicant to agree to pay private rates for a set period before applying for Medicaid. A security deposit from a private-pay resident may not exceed one month's charges, must be held in an interest-bearing escrow account in a Massachusetts bank, and must be returned with interest within 30 days after notice that the resident is eligible for Medicaid long-term care coverage. A home with no Medicaid, Medicare or other public-program contract must disclose in writing, at admission and yearly, that a resident may be transferred or discharged if the resident stops paying privately.
Michigan: Michigan law bars a nursing home from requiring, as a condition of admission or continued stay, that a resident remain private-pay for a set period before applying for Medicaid, or that someone pay the private rate for a set period first. A home may not require an applicant to promise not to apply for Medicaid. A new contract must be signed when the payment source changes. If a home leaves Medicaid but keeps operating, it may not involuntarily discharge residents who lived there the day before it withdrew, except for the reasons the law allows.
Minnesota: Minnesota requires nursing homes that take Medical Assistance not to charge private-pay residents more than the state-approved Medical Assistance rate for similar services (a higher rate is allowed for a private room, and for optional special services charged equally). These homes may not treat residents differently, or discriminate in admissions, services or room assignment, based on public assistance status, and may not require a third-party payment guarantee. When a private-pay resident who has not yet been screened is admitted, the home must tell the resident and spouse or health care agent about resources they may keep if the resident applies for Medical Assistance.
Missouri: Missouri law says that if the Family Support Division cannot decide Medicaid eligibility for a nursing home resident within 60 days of a completed application for nursing facility services, the resident is treated as Medicaid eligible until the application is approved or denied; benefits cannot start before the application date. This section is set to expire Sept. 30, 2029.
New York: Once a resident becomes eligible for Medicaid after admission, the home may charge only Medicaid-allowable amounts. A transfer or discharge for nonpayment is allowed only if a charge is not in dispute, no appeal of a denial of benefits is pending, or funds for payment are actually available and the resident refuses to cooperate with the home in obtaining them.
Ohio: A resident who has applied for Medicaid is not treated as failing to pay unless the application is denied and, if appealed, the denial is upheld. A home that does not take Medicaid must tell each prospective resident in writing before admission that they may be discharged if they cannot pay.
Rhode Island: A resident who has paid privately for at least six months in a home that takes Medicaid may stay at the Medicaid rate after their own money runs out, if they qualify for Medicaid and a bed at that level of care is available.
Virginia: Virginia law bars nursing home contracts that restrict a resident's ability to apply for and receive Medicaid or that require a set period of private-pay residency before applying; the home may require the resident to tell it when a Medicaid application is made. Contracts may not require a deposit or prepayment from Medicaid recipients or let the home refuse retroactive Medicaid benefits. Homes certified for Medicare or Medicaid may not require a third-party guarantee of payment as a condition of admission or continued stay.
Wisconsin: In a Medicaid-certified nursing home, if a resident becomes eligible for Medicaid after admission, only charges allowed under Medicaid may be counted when the home seeks to transfer or discharge the resident for nonpayment. A resident may not be involuntarily discharged for nonpayment if the resident needs ongoing care, has not been accepted elsewhere, and their Medicaid funding is cut because the home does not provide the level or type of care needed or is found to be an institution for mental diseases. Homes must offer the same basic services to all residents regardless of payment source and may not assign residents to a wing or area based on source or amount of payment (Medicare-certified parts excepted).

Checked against state sources in Oct 2026. State rules are added here as each state's rules are checked against its own sources.

What must the notice say?

The home must give the notice in writing to the resident and the resident's representative, in a language and manner they understand, and send a copy to the long-term care ombudsman. It must include:

the reason for the transfer or discharge;
the effective date;
where the resident is being moved;
a statement of the right to appeal, with the name, mailing and email address and phone number of the office that receives appeal requests, and how to get an appeal form and help completing and submitting it;
the name, mailing and email address and phone number of the State Long-Term Care Ombudsman;
for a resident with an intellectual or developmental disability, a mental disorder or a related disability, the mailing and email address and phone number of the protection and advocacy agency.

If any of this changes before the move, the home must update everyone who got the notice as soon as practicable. CMS guidance says a significant change, such as a new destination, requires a new notice, which restarts the 30 days.

When is less than 30 days' notice allowed?

The notice may be given as soon as practicable, instead of 30 days ahead, when:

the safety of people in the home would be endangered;
the health of people in the home would be endangered;
the resident's health has improved enough for a quicker move;
the resident's urgent medical needs require an immediate move; or
the resident has lived in the home for less than 30 days.

Differs by stateState discharge and appeal rules

Some states add their own notice rules and appeal deadlines.

Arizona: Arizona licensing rules require a nursing care institution to transfer or discharge a resident if it is not authorized or able to meet the resident's needs, or if the resident's behavior threatens the health or safety of the resident or others. The record must include a 30-day written notice except in an emergency or when a physician or designee determines the resident no longer needs nursing care institution services. A home may discharge for failure to pay only if the resident or representative gets a 30-day written notice explaining the right to appeal. Except in an emergency, written discharge follow-up instructions must include the state long-term care ombudsman's name, address and phone number.
California: The federal transfer and discharge rules (as in effect in July 2017) apply to every skilled nursing facility in California, whatever pays for the resident's care and even if the home is not Medicare or Medi-Cal certified, and every resident may appeal an involuntary transfer or discharge. Since January 1, 2025, the notice must say whether the home takes Medi-Cal and Medicare. Appeals are heard by the Department of Health Care Services Office of Administrative Hearings and Appeals, 916-445-9775.
Florida: A home must give at least 30 days' notice of a transfer or discharge. Notice may come later, as soon as practicable, when the move is necessary for the resident's welfare and the home cannot meet the resident's needs, or when the health or safety of other residents or staff would be endangered, and a physician documents this in the medical record. The notice uses a state form describing appeal rights, and a copy goes to the resident's guardian or representative and to the local ombudsman council within 5 business days of signature. A resident of a Medicaid- or Medicare-certified home may ask for a hearing with the Department of Children and Families within 90 days of the notice; asking within 10 days stops the transfer or discharge until the hearing decision.
Georgia: Under Georgia's long-term care residents' rights rules, a facility must give written notice at least 30 days before an involuntary transfer or discharge based on a physician's determination that not transferring the resident will result in injury or illness to the resident or others, nonpayment of allowable fees, or the facility not participating in (or ceasing to participate in) the program that pays for the resident's care. The notice goes to the resident, the guardian (or representative if there is no guardian) and the resident's physician; a copy goes to the ombudsman if the resident wishes. The resident may request a hearing from the Department of Community Health. Except in emergencies or for nonpayment, no transfer may take place until appeal rights are used up. A move to another bed in the same facility needs 15 days' written notice.
Illinois: Since January 1, 2026, a home must give at least 30 days' written notice before an involuntary transfer or discharge (it was 21 days), except in emergencies, safety situations and a few other cases set by law. Copies go to the Department of Public Health, the State Long-Term Care Ombudsman, the resident, the resident's representative and the resident's managed care organization. The resident may ask the Department of Public Health for a hearing within 10 days after receiving the notice; the request generally stops the move until the hearing and any appeal are decided.
Indiana: Indiana's licensing rule requires the written transfer or discharge notice, on a state form, to go to the resident, a family member and legal representative if known, the local long-term care ombudsman (for involuntary moves), and the person or agency responsible for the resident's placement. The notice must generally be given at least 30 days before the move; shorter notice is allowed in listed situations, such as danger to health or safety, urgent medical needs, or a stay of under 30 days. The resident may appeal by written hearing request to the Indiana Department of Health postmarked within 10 days of receiving the notice. The department holds an informal hearing at the home within 23 days and decides within 30 days; the home must prove the move is allowed. A resident who appeals may not be moved within 34 days of the notice except in emergencies. If the reason is nonpayment, the resident may pay the balance owed and stay.
Iowa: Iowa requires written notice at least 30 days before an involuntary transfer or discharge, with exceptions (for example emergencies, where written notice must be given before or within 48 hours after the transfer or discharge). Copies go to the state licensing agency, the responsible party, the primary care provider, the placing agency and the long-term care ombudsman office. The resident may request a hearing from DIAL, in writing or verbally, within 7 days of receiving the notice; the hearing is held before an administrative law judge no later than 14 days after DIAL receives the request, unless either party asks for an extension due to emergency circumstances. Except in emergencies, the request stops the move until a final decision, including appeals.
Kansas: Under Kansas rules, an adult care home, including a nursing home, may transfer or discharge a resident involuntarily only if the move is necessary for the resident's welfare and the resident's needs cannot be met there, the safety or health of others is endangered, the resident has not paid after reasonable and appropriate notice, or the home closes. Federal rules for Medicare/Medicaid-certified homes also apply. The home must notify the resident, their legal representative and, if known, a designated family member, and give written notice at least 30 days ahead unless others' safety is endangered or urgent medical needs require immediate transfer. The notice must list the reason, effective date, and the address and phone of the state complaint program and the state long-term care ombudsman.
Massachusetts: MassHealth's nursing facility transfer and discharge rules define a resident as anyone receiving care in a nursing facility, whether or not the person is a MassHealth member. The home must give at least 30 days' written notice (or notice as soon as practicable in listed situations, such as danger to health or safety, urgent medical needs, or a stay of under 30 days), hand-delivered to the resident and mailed to the legal representative, in 12-point or larger type, stating the right to a hearing before MassHealth's Board of Hearings, giving the name, address and phone number of the local long-term-care ombudsman office, and stating that free legal assistance may be available. If the hearing request reaches the Board within 30 days of the notice, the home must not move the resident until 30 days after the decision. By state law, a resident who requests a hearing may not be discharged unless a referee finds the home prepared the resident for a safe and orderly move to another safe and appropriate place.
Michigan: Michigan allows involuntary transfer or discharge only for medical reasons, the patient's welfare, the welfare of other patients or staff, or nonpayment (except where federal Medicaid law prohibits it), with 30 days' written notice except in limited cases. Copies go to the state, the patient, next of kin or representative, and whoever arranged the placement; LARA's form also goes to the State Long Term Care Ombudsman. The patient may request a hearing with LARA; the law allows 10 days after receiving the notice, and LARA's notice form says the request must be received by LARA within 10 days of the date of the notice. A hearing request stops the move pending a decision, and Medicaid funding continues during the appeal for Medicaid residents. If the reason is nonpayment, the patient may pay up to the discharge date and stay.
Minnesota: Minnesota law says residents may not be arbitrarily transferred or discharged and must get written notice with the reason at least 30 days before discharge and at least 7 days before a move to another room in the home. The notice must include the right to contest and the address and phone number of the ombudsman. The notice period may be shortened in situations outside the home's control, such as a change in the resident's medical or treatment program, the resident's own or another resident's welfare, or nonpayment (unless the public program paying for care prohibits it), as documented in the medical record. A resident may appeal to the Minnesota Department of Health in writing within 30 days of the notice; the hearing must be held within 14 days after the request is received, at the home where the resident lives, unless that is impractical or the parties agree otherwise. A resident of a certified home who appeals on time may not be discharged until the appeal is resolved.
Missouri: Missouri's resident-rights law allows transfer or discharge only for medical reasons, the resident's welfare or that of other residents, or nonpayment; state rules list the permitted reasons as needs that cannot be met, improved health, endangered safety or health of others, nonpayment after notice, or the home closing. Written notice is required at least 30 days ahead except in emergencies. State rules require the notice to go to the resident, any legally authorized representative and at least one family member, or the regional ombudsman if no family member is known. The resident may appeal to the Department of Health and Senior Services within 30 days of receiving the notice (DHSS Appeals Unit, 573-522-1699). Filing an appeal stays the discharge unless the home shows good cause.
New Jersey: In a 2021 final agency decision, New Jersey's Medicaid agency (DMAHS) wrote that the regulations on involuntary nursing home discharge are federal. According to the state ombudsman, residents, regardless of payer source, have the right under federal law to appeal a transfer or discharge notice to the state Medicaid agency, and the notice must include contact information for its Fair Hearing Unit. The state ombudsman says notices should never list the ombudsman as the appeals agency. Appeals are heard through the Office of Administrative Law, and DMAHS issues the final agency decision.
New York: A home must give at least 30 days' written notice before a transfer or discharge it starts, to the resident, the resident's lawful representative (if any), a known family member and the long-term care ombudsman; shorter notice is allowed in limited cases. Before starting a transfer or discharge, a home must use its best efforts to find a placement other than temporary housing such as a shelter or hotel, and may not discharge a resident to another person's home without the written consent of both. A resident may ask the Department of Health for a hearing within 60 days of receiving the notice and, except in cases of imminent danger, may stay in the home during the appeal if the request is made within 15 days of receiving it. The home has the burden of proof.
North Carolina: North Carolina requires nursing homes to use the state's Notice of Transfer or Discharge form; a notice without the completed form is invalid. The resident must be handed the form on the day it is dated, a copy must be mailed the same day to a family member or legal representative if contact information is available, and a Nursing Home Hearing Request Form must be given with it. The appeal goes to the DHHS Hearing Unit and must be received within 11 calendar days of the notice date. Hearings are by telephone unless an in-person hearing in Raleigh is requested. NC Medicaid policy says the home may not discharge while an appeal is pending unless that would endanger health or safety.
Ohio: The home must give the resident written notice, and send the resident's sponsor notice by certified mail, at least 30 days before a transfer or discharge, with a copy to the Ohio Department of Health; shorter notice is allowed in listed situations, such as emergencies. The resident or sponsor may ask the Department of Health in writing for a hearing within 30 days of receiving the notice; a request within 10 days generally stops the discharge until the hearing decision. The hearing is held at the home, within 10 days of the request unless the resident and home agree otherwise.
Pennsylvania: In a home enrolled in Medical Assistance, any resident, whether on Medicaid or not, may appeal a transfer or discharge to the Department of Human Services. Under a department statement of policy, the appeal must be filed within 30 days of proper notice (the time does not start until proper notice is given); it can be made by letter, which must include a copy of the home's notice and the reasons the resident disagrees, and there is no fee. If a home closes, residents must get written notice at least 60 days before the closure and cannot be required to leave sooner than 30 days after the notice, unless the Department of Health decides otherwise for health and safety.
Tennessee: Tennessee rules say a nursing home may not make an involuntary transfer or discharge until it has first informed the state licensing agency (the rule says 'the department'; nursing home licensing moved to the Health Facilities Commission in 2022) and the area long-term care ombudsman, and not until five business days after they are notified, except in disasters or medical emergencies or if the agencies earlier say they will not intervene. TennCare's required notice form says copies go to the resident and representative, the TennCare Commissioner's Designee, the State and District LTC Ombudsman and the Health Facilities Commission. The form says residents of Medicare skilled nursing or Medicaid nursing facilities may appeal to TennCare (1-833-582-1224); if they appeal within 30 days, the home usually cannot make them move until a decision.
Texas: In a Medicaid-certified home, a resident has 90 days to appeal a discharge through a state fair hearing. If the appeal is filed before the discharge date, the resident may stay until the hearing officer decides, except in nonpayment cases and the situations the rule lists for short-notice discharge (danger to the health or safety of others, urgent medical needs, improved health, or a stay of less than 30 days). If the discharge is found inappropriate, the home must readmit the resident immediately or to the next available bed. Before an immediate discharge for health or safety reasons, other than to a hospital, the home must call the State Long-Term Care Ombudsman office.
Vermont: Vermont law requires written notice, with the reasons, at least 30 days before a discharge and at least 72 hours before a move to another room within the home. When health or safety is in danger, or the resident's urgent medical needs require an immediate move, notice is given as soon as practicable. State rules give a resident 10 business days from receiving the notice to appeal, and the notice must say that the resident may stay while the appeal is decided.
Virginia: Virginia law allows a nursing home to transfer or discharge a resident only for documented medical needs, to protect the resident or others from physical or emotional injury, for nonpayment (except as federal Medicare/Medicaid law prohibits), or with the resident's informed voluntary consent. Except in an emergency, the home must first consult the resident, the resident's family or responsible party and the attending physician; for an involuntary move the physician or medical director must approve it in writing in the record. Except in an emergency involving the resident's health or well-being, Virginia's own statute requires written notice at least five days before an involuntary transfer or discharge (federal rules for certified homes generally require 30 days).
Wisconsin: Wisconsin rules require at least 30 days' notice, with reasons, of a transfer or discharge that the resident or guardian did not request, to the resident, the resident's physician and, if known, a family member, legal counsel, guardian or other responsible person, unless the resident's continued presence endangers the health, safety or welfare of the resident or others. The notice must give the name, address and phone number of the Board on Aging and Long Term Care and state the right to appeal. Except in danger situations or respite stays, a planning conference must be held at least 14 days before an involuntary move. To appeal, the resident sends a letter to the nearest DHS Division of Quality Assurance regional office within 7 days after receiving the notice, with a copy to the administrator; a timely appeal stops the move until DQA decides. This appeal process does not apply when the resident's continued presence poses a danger to the health, safety or welfare of the resident or others. DQA decides within 14 days after the home's justification, and either side may then appeal to the Division of Hearings and Appeals within 5 days.

Checked against state sources in Oct 2026. State rules are added here as each state's rules are checked against its own sources.

How does the appeal work?

Every state must have one. Federal rules require each state to give a resident a way to appeal a notice of transfer or discharge, and the state Medicaid agency must offer a hearing.
Staying during the appeal. While the appeal is pending, the home may not transfer or discharge the resident unless failing to do so would endanger the health or safety of the resident or others, and the home must document that danger.
Who can help. The resident may speak for themselves or use a lawyer, a relative, a friend or another spokesperson.
Who decides. The hearing officer must be impartial and not involved in the original decision.
If the resident wins. The agency must, where appropriate, provide for admission or readmission to a facility.

What about a hospital stay?

CMS guidance treats an emergency trip to the hospital as a transfer, not a discharge, because the resident's return is generally expected. If the home decides the resident cannot return, it must follow the discharge rules above, and CMS says that decision must rest on the resident's condition when they seek to return, not when they left. CMS guidance also says a resident who appeals while in the hospital must be allowed to return while the appeal is pending, unless there is evidence the home cannot meet their needs or the return would endanger health or safety. See nursing home bed hold.

What must happen before the move?

The home must prepare and orient the resident for a safe and orderly move, in a way the resident can understand, and document it. It must send the new provider the information it needs, including contact details for the responsible practitioner and the resident representative, advance directive information, special instructions or precautions, and the goals of the care plan. Federal rules also require a discharge planning process that involves the resident and their representative.

The home must apply the same transfer and discharge policies to every resident, whatever pays for their care.

What if the nursing home closes?

Closure is one of the six reasons. Before closing, the administrator must give written notice to the state survey agency, the State Long-Term Care Ombudsman, residents and their representatives, with a plan for relocating residents.

Differs by stateLong-term care ombudsman, by state

Arizona: Arizona Long-Term Care Ombudsman Program (Office of Arizona State Long-Term Care Ombudsman Program) · 602-542-6454 (Extension 9 (state office). Regional programs: Maricopa County 602-264-4357; Pima County 520-790-7262; Yavapai, Coconino, Navajo and Apache counties 877-521-3500; Mohave, La Paz and Yuma counties 928-217-7114; Pinal and Gila counties 520-836-2758; Cochise, Graham, Greenlee and Santa Cruz counties 520-432-2528 ext. 206. Navajo Nation 602-542-6454 or 602-542-6432; Inter-Tribal Council of Arizona 800-591-9370.)
California: Statewide Ombudsman Hotline · 1-800-231-4024 (24 hours a day, 7 days a week)
Florida: Florida Long-Term Care Ombudsman Program · 1-888-831-0404
Georgia: Georgia Long-Term Care Ombudsman Program · 1-866-552-4464 (Select option 5 (per the Division of Aging Services page).)
Illinois: Illinois Long-Term Care Ombudsman Program · 1-800-252-8966 (Senior HelpLine)
Indiana: Indiana Long-Term Care Ombudsman Program · 1-800-622-4484 (Also 317-232-7134. Email: LongTermCareOmbudsman@ombudsman.IN.gov)
Iowa: Office of the State Long-Term Care Ombudsman · 866-236-1430 (Toll-free. Relay Iowa TTY: 1-800-735-2942. The page also offers an online complaint form.)
Kansas: Kansas Office of the State Long-Term Care Ombudsman · 877-662-8362 (Toll-free. Topeka office 785-296-3017. Monday-Friday, 8:30 am - 5:00 pm.)
Maine: Maine Long-Term Care Ombudsman Program · 1-800-499-0229
Massachusetts: Massachusetts Long-Term Care Ombudsman Program · 617-222-7495 (Long-Term Care Ombudsman line listed on the state's nursing and rest home ombudsman page. Local ombudsman programs are listed by city/town on the same page. MassOptions: 800-243-4636.)
Michigan: Michigan Long Term Care Ombudsman Program (MLTCOP) · 1-866-485-9393 (Toll-free line to reach a local ombudsman. Program office: 517-827-8040; email MLTCOP@meji.org.)
Minnesota: Office of Ombudsman for Long-Term Care (OOLTC) · 1-800-657-3591 (Also 651-431-2555. Calls answered 8:00 AM - 4:00 PM, Monday to Friday. TDD/TTY: 711. Email MBA.OOLTC@state.mn.us; fax 651-431-7452.)
Missouri: Missouri Long-Term Care Ombudsman Program · 800-309-3282 (Email: LTCOmbudsman@health.mo.gov)
New Hampshire: Office of the Long-Term Care Ombudsman · 1-800-442-5640
New Jersey: New Jersey Long-Term Care Ombudsman · 1-877-582-6995 (Fax 1-609-943-3479. Email: ombudsman@ltco.nj.gov. Mail: P.O. Box 852, Trenton, NJ 08625-0852.)
New York: New York State Long Term Care Ombudsman Program · 1-855-582-6769
North Carolina: North Carolina Long-Term Care Ombudsman Program · 919-855-3400 (Office of the State Long-Term Care Ombudsman, Raleigh. Regional ombudsmen (16 offices in Area Agencies on Aging) are listed by county in a document linked from the program page.)
Ohio: Office of the State Long-Term Care Ombudsman · 1-800-282-1206
Pennsylvania: Pennsylvania Long-Term Care Ombudsman Program · 717-783-8975
Rhode Island: Office of the Rhode Island State Long Term Care Ombudsman · 1-888-351-0808
Tennessee: Tennessee Long-Term Care Ombudsman Program · 877-236-0013 (Toll-free; routes callers to the District Ombudsman program for their area. State office: 615-253-5412.)
Texas: Office of the State Long-Term Care Ombudsman · 1-800-252-2412
Vermont: Vermont Long-Term Care Ombudsman Project · 1-800-889-2047 (ext. 3)
Virginia: Virginia Long-Term Care Ombudsman Program (Office of the State Long-Term Care Ombudsman) · 800-552-5019 (Toll-free. Also 804-565-1600.)
Wisconsin: Wisconsin Long Term Care Ombudsman Program · 1-800-815-0015 (Email: BOALTC@wisconsin.gov.)

Checked against state sources in Oct 2026. Contacts are added here as each state's offices are checked against their own pages.

For every state, see how to reach the ombudsman and file a complaint, and residents' rights.