Shown verbatim: the complete text as captured from the official PDF posted by the Maryland General Assembly, fetched 2026-09-25. Page and line markers are part of the official record; nothing is edited or removed. This is the chaptered version. The official bill page.
WES MOORE, Governor Ch. 25
Chapter 25
(Senate Bill 493)
AN ACT concerning
Nursing Facilities – Involuntary Discharge or Transfer
FOR the purpose of prohibiting certain facilities from involuntarily transferring or
discharging a resident to certain housing or before receiving certain confirmations;
altering the information required to be included in a certain notice or updated new
notice; requiring that a certain notice or updated new notice be provided to certain
residents at least a certain period of time before an involuntary discharge or transfer;
establishing time requirements that apply to the discharge or transfer of a resident
if a new notice of involuntary discharge or transfer of the resident is provided;
requiring that a post discharge plan contain certain information; and generally
relating to nursing facilities and involuntary discharges and transfers.
BY repealing and reenacting, with amendments,
Article – Health – General
Section 19–345 and 19–345.1
Annotated Code of Maryland
(2023 Replacement Volume and 2025 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
19–345.
(a) A resident of a facility may not be transferred or discharged from the facility
involuntarily except for the following reasons:
(1) The transfer or discharge is necessary for the resident’s welfare and the
resident’s needs cannot be met in the facility;
(2) The transfer or discharge is appropriate because the resident’s health
has improved sufficiently so that the resident no longer needs the services provided by the
facility;
(3) The health or safety of an individual in a facility is endangered;
(4) The resident has failed, after reasonable and appropriate notice, to pay
for, or under Medicare or Medicaid or otherwise, to have paid for a stay at the facility; or
(5) The facility ceases to operate.
–1–
Ch. 25 2026 LAWS OF MARYLAND
(b) A RESIDENT OF A FACILITY THAT IS TRANSFERRED OR DISCHARGED
FROM THE FACILITY INVOLUNTARILY MAY NOT BE TRANSFERRED OR DISCHARGED:
(1) TO A LOCATION OTHER THAN THE LOCATION IDENTIFIED IN THE
NOTICE REQUIRED UNDER § 19–345.1(B)(3) OF THIS SUBTITLE, SUCH AS A HOTEL,
SHELTER, OR OTHER TEMPORARY HOUSING;
(2) BEFORE THE FACILITY TO WHICH THE RESIDENT IS TO BE
TRANSFERRED HAS CONFIRMED THAT:
(I) THE RESIDENT MAY BE TRANSFERRED TO THE FACILITY;
AND
(II) THE FACILITY IS PREPARED TO ACCEPT THE RESIDENT.
(C) (1) A Medicaid certified facility may not:
(i) Include in the admission contract of a resident any requirement
that, to stay at the facility, the resident will be required to pay for any period of time or
amount of money as a private pay resident for any period when the resident is eligible for
Medicaid benefits; or
(ii) Transfer or discharge a resident involuntarily because the
resident is a Medicaid benefits recipient.
(2) (i) Except as provided in subparagraph (ii) of this paragraph, a
Medicaid certified facility is presumed to be transferring or discharging a resident in
violation of this subsection, if the resident is or becomes eligible for Medicaid benefits.
(ii) A Medicaid certified facility is not presumed to be transferring or
discharging a resident in violation of this subsection for transferring or discharging a
resident for nonpayment for services while the resident was ineligible for assistance under
the medical assistance program.
19–345.1.
(a) (1) A facility shall provide the resident with written notice of:
[(1)] (I) Any proposed discharge or transfer; and
[(2)] (II) The opportunity for a hearing in accordance with the provisions
of this section before the discharge or transfer.
–2–
WES MOORE, Governor Ch. 25
(2) THE NOTICE REQUIRED UNDER PARAGRAPH (1) OF THIS
SUBSECTION SHALL INCLUDE, AT A MINIMUM, THE INFORMATION LISTED UNDER
SUBSECTION (B) OF THIS SECTION.
(b) The Department shall prepare and provide each facility with a standardized
form that provides, in clear and simple language, at least the following information:
(1) Notice of the intended discharge or transfer of the resident, including
the proposed date of the intended discharge or transfer, which may change as a result of
an appeal or the discharge planning process;
(2) Each reason for the discharge or transfer;
(3) The location to which the resident will be discharged or transferred,
which may change as a result of an appeal or the discharge planning process;
(4) The name of the social worker or other professionally qualified staff,
which may change during the discharge planning process, who:
(i) Is designated to provide social services and discharge planning
services to the resident in connection with the discharge or transfer; and
(ii) Will be responsible for the development of the post discharge
plan of care under subsection (g) of this section;
(5) A proposed date within 10 days after the date of the notice for a meeting
between the resident, the resident’s representative, and facility staff to develop the post
discharge plan of care under subsection (g) of this section;
(6) (I) The right of the resident to request a hearing;
(II) THE NAME, MAILING ADDRESS, E–MAIL ADDRESS, AND
TELEPHONE NUMBER OF THE ENTITY TO WHICH THE RESIDENT MUST SUBMIT A
REQUEST FOR A HEARING; AND
(III) INSTRUCTIONS FOR OBTAINING, COMPLETING, AND
SUBMITTING A REQUEST FOR A HEARING;
(7) The right of the resident to consult with any lawyer the resident
chooses;
(8) The availability of the services of the Legal Aid Bureau MARYLAND
LEGAL AID, the Older American Act Senior Legal Assistance Programs, and other
agencies that may provide assistance to individuals who need legal counsel;
–3–
Ch. 25 2026 LAWS OF MARYLAND
(9) (I) The availability of the Long–Term Care Ombudsman Program to
assist the resident; AND
(II) THE MAILING ADDRESS, E–MAIL ADDRESS, AND TELEPHONE
NUMBER OF THE LONG–TERM CARE OMBUDSMAN PROGRAM;
(10) (I) THE AVAILABILITY OF DISABILITY RIGHTS MARYLAND TO
ASSIST RESIDENTS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES,
MENTAL DISORDERS, AND RELATED DISORDERS; AND
(II) THE MAILING ADDRESS, E–MAIL ADDRESS, AND TELEPHONE
NUMBER OF DISABILITY RIGHTS MARYLAND; and
[(10)] (11) The provisions of this section.
(c) Except as otherwise provided in this section, at least 30 days before the facility
involuntarily transfers or discharges a resident, the facility shall:
(1) Provide to the resident the written notice required under subsection (a)
of this section; and
(2) Provide the written notice required under subsection (a) of this section
to:
(i) The resident;
(ii) The next of kin, guardian, or any other individual known to have
acted as the resident’s representative, if any;
(iii) The Long–Term Care Ombudsman; and
(iv) The Department.
(d) (1) (i) In accordance with regulations adopted by the Secretary, the
facility shall provide the resident with an opportunity for a hearing on the proposed
transfer or discharge.
(ii) The regulations adopted by the Secretary may provide for the
establishment of an escrow account when:
1. The basis for the discharge is nonpayment; and
2. The resident continues to reside in the facility while the
appeal is pending.
–4–
WES MOORE, Governor Ch. 25
(2) Except as otherwise provided in this subsection, hearings on proposed
transfers or discharges shall be conducted in accordance with the provisions of Title 10,
Subtitle 2 of the State Government Article and the Medicaid Fair Hearing Procedures.
(3) Any hearing on a proposed discharge or transfer of a resident:
(i) Is not a contested case as defined in § 10–202 of the State
Government Article; and
(ii) May not include the Secretary as a party.
(4) A decision by an administrative law judge on a proposed discharge or
transfer of a resident:
(i) Is not a decision of the Secretary;
(ii) Unless appealed, is final and binding on the parties; and
(iii) May be appealed in accordance with § 10–222 of the State
Government Article as if it were a contested case but the appeal does not automatically
stay the decision of the administrative law judge.
(e) The facility shall provide the written notice required in subsection (a) of this
section as soon as practicable before discharge or transfer if[:
(1) An] AN emergency exists and health or safety of the resident or other
residents would be placed in imminent and serious jeopardy if the resident were not
transferred or discharged from the facility as soon as possible[; or
(2) The resident has not resided in the facility for 30 days].
(f) (1) If the information in the notice provided under subsection (c) of this
section changes before the discharge or transfer, the facility shall provide the changes to
the recipients of the notice as soon as practicable after the new information becomes
available.
(2) IF AN UPDATED NOTICE IS PROVIDED UNDER THIS SUBSECTION,
THE RESIDENT MAY NOT BE DISCHARGED OR TRANSFERRED FOR AT LEAST 30 DAYS
AFTER THE UPDATED NOTICE HAS BEEN PROVIDED TO THE RESIDENT.
(2) IF A NEW NOTICE IS PROVIDED UNDER PARAGRAPH (1) OF THIS
SUBSECTION, THE FOLLOWING TIME REQUIREMENTS APPLY TO THE DISCHARGE OR
TRANSFER OF THE RESIDENT:
–5–
Ch. 25 2026 LAWS OF MARYLAND
(I) THE RESIDENT MAY NOT BE DISCHARGED OR
TRANSFERRED FOR AT LEAST 30 DAYS AFTER THE NEW NOTICE HAS BEEN PROVIDED
TO THE RESIDENT IF THE NEW NOTICE IS PROVIDED BEFORE:
1. THE EXPIRATION OF THE TIME PERIOD REQUIRED
UNDER SUBSECTION (C) OF THIS SECTION; OR
2. THE DATE OF AN ORDER OF DISCHARGE ISSUED BY AN
ADMINISTRATIVE LAW JUDGE UNDER SUBSECTION (D) OF THIS SECTION; AND
(II) IF THE NEW NOTICE IS PROVIDED AFTER A DATE DESCRIBED
UNDER ITEM (I) OF THIS PARAGRAPH:
1. IF THE ORIGINAL NOTICE INDICATED A DISCHARGE
LOCATION THAT WAS A LICENSED SKILLED NURSING FACILITY AND THE NEW NOTICE
CHANGES THE DATE OF DISCHARGE OR TRANSFER ONLY, THE RESIDENT MAY BE
DISCHARGED ON THE EARLIEST DATE THAT A BED IS AVAILABLE AT THE FACILITY;
2. IF THE NEW NOTICE CHANGES THE LOCATION OF
DISCHARGE OR TRANSFER FROM A LICENSED SKILLED NURSING FACILITY TO A
DIFFERENT LICENSED SKILLED NURSING FACILITY, THE RESIDENT MAY NOT BE
DISCHARGED OR TRANSFERRED FOR AT LEAST 7 DAYS AFTER THE NEW NOTICE HAS
BEEN PROVIDED TO THE RESIDENT; AND
3. IF THE NEW NOTICE CHANGES THE LOCATION OF
DISCHARGE OR TRANSFER FROM A LICENSED SKILLED NURSING FACILITY TO A
LOCATION THAT IS NOT A LICENSED SKILLED NURSING FACILITY BUT IS OTHERWISE
DETERMINED TO BE A SAFE DISCHARGE LOCATION UNDER AN APPROPRIATE
CLINICAL EVALUATION AND AS SET FORTH IN THE POST DISCHARGE PLAN OF CARE,
THE RESIDENT MAY NOT BE DISCHARGED OR TRANSFERRED FOR AT LEAST 30 DAYS
AFTER THE NEW NOTICE HAS BEEN PROVIDED TO THE RESIDENT.
(3) AN UPDATED A NEW NOTICE PROVIDED UNDER THIS SUBSECTION
SHALL INDICATE:
(I) INDICATE ANY DIFFERENCES BETWEEN THE PRIOR NOTICE
AND THE UPDATED NEW NOTICE; AND
(II) INCLUDE A NOTICE OF THE RIGHT TO APPEAL THE NEW
NOTICE:
1. FOR ANY DISCHARGE OR TRANSFER DESCRIBED
UNDER PARAGRAPH (2)(I) OF THIS SUBSECTION; OR
–6–
WES MOORE, Governor Ch. 25
2. FOR A DISCHARGE OR TRANSFER DESCRIBED UNDER
PARAGRAPH (2)(II)3 OF THIS SUBSECTION, IF THE UNDERLYING BASIS OF THE
ORIGINAL NOTICE HAS CHANGED.
(4) FOR A DISCHARGE OR TRANSFER DESCRIBED UNDER PARAGRAPH
(2)(II)1 OR 2 OF THIS SUBSECTION, A NEW NOTICE IS NOT REQUIRED TO INCLUDE A
NOTICE OF THE RIGHT TO APPEAL THE NEW NOTICE.
(g) (1) Before any discharge or transfer and subject to paragraphs (4) and (5)
of this subsection, a facility shall develop a post discharge plan of care for the resident to
assist the resident with adjusting to the resident’s new living environment and that:
(i) Addresses the resident’s post discharge goals of care and
treatment preferences; [and]
(ii) Identifies each of the resident’s reasonably anticipated medical
and basic needs after discharge or transfer and establishes a plan for meeting those needs;
(III) IDENTIFIES THE ADDRESS AT WHICH THE RESIDENT WILL
RESIDE POST DISCHARGE; AND
(IV) IN ACCORDANCE WITH REGULATIONS ADOPTED BY THE
SECRETARY, PROVIDES A SAFE, SECURE, AND SUSTAINABLE ENVIRONMENT FOR
THE RESIDENT.
(2) The facility shall designate a social worker or other professionally
qualified staff member to coordinate the development of the resident’s post discharge plan
of care.
(3) The facility shall, if possible, meet with the resident and, with the
resident’s consent, the resident’s representative within 10 days after providing the notice
required under subsection (a) of this section to discuss the post discharge plan of care for
the resident.
(4) (i) The resident’s post discharge plan of care shall be developed with
the participation of the resident and, with the resident’s consent, the resident’s
representative.
(ii) If the post discharge plan of care was developed without the
participation of the resident or the resident’s representative, the facility shall include in
the resident’s medical record an explanation of why the resident or the resident’s
representative did not participate.
–7–
Ch. 25 2026 LAWS OF MARYLAND
(5) The resident’s post discharge plan of care shall be developed in
consultation with:
(i) The resident’s attending physician;
(ii) A registered nurse responsible for the care of the resident; and
(iii) Any other appropriate staff or professional involved with
meeting the resident’s medical needs.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2026.
Approved by the Governor, April 14, 2026.
–8–Every fact on this page links to its source, starting with the official bill record.